法美两公司的clopidogrel显著改善心脏病患者生存率

在一项涉及了50000例患者的新药临床试验中，发现价格便宜的抗血小板药物将clopidogrel添加到标准治疗之中，能够将心脏病发作患者入院治疗1周后发生其它动脉阻塞或者心脏病二次发作的几率降低了36％，

在该项临床试验中患者有急性ST段升高的心肌缺血性梗死（STEMI）。在30天之后clopidogrel把心血管源性死亡、心肌梗死再发以及导致紧急血管再造的再发性缺血减少了20％。这项试验发现无论患者性别、接受的标准治疗方案（纤维蛋白溶解类型或者肝素类型）或者心脏病发作的部位有何不同，结果都保持一致。

另外一项相同的临床试验发现：除了标准治疗方案之外，使用clopidogrel治疗心脏病发作患者，把死亡的相对危险降低了7％，心脏病复发的危险降低了9％。英国牛津大学Zheng Ming Chen医生说：“这项临床试验还显示：治疗并不会显著增加胎儿的风险或者与clopiogrel治疗相关的输血出血风险。”Zheng Ming Chen医生在2005年3月美国奥兰多(FL, USA)举行的美国心脏病学院年会上报道了这些试验结果。

其它参与该项临床试验的研究人员分别来自哈佛医学院(Boston, MA, USA)、Brigham与妇女医院(Boston, MA, USA)、中国北京阜外医院以及中国医学科学院。重大出血与颅内出血发生率在两个治疗组中类似。Clopidogrel(clopidogrel bisulfate)在全球范围内是由Sanofi-Aventis公司 (Paris, France)和Bristol-Myers Squibb 公司 (Princeton, NJ, USA)推向市场的，名称分别是Plavix与Iscover。
 
Drug Improves Heart-Attack Survival
 
One trial in a new study involving nearly 50,000 patients has shown that the inexpensive anti-platelet agent clopidogrel added to standard therapy reduced the odds of heart attack patients having another occluded artery or a second heart attack by 36% after one week of hospitalization.

Patients in the study had acute ST-segment elevation myocardial infarction (STEMI). After 30 days, clopidogrel reduced the odds of cardiovascular death, recurrent infarction, and recurrent ischemia leading to urgent revascularization by 20%. The results were consistent regardless of gender, the standard therapy received (type of fibrinolytic or type of heparin), or the location of the heart attack.

Another trial in the same study found that treating heart attack patients with clopidogrel in addition to standard therapy reduced the relative risk of death by 7% and the risk of a recurrent heart attack by 9%. “The study also showed that there was no significant increase in the risk of fetal or transfused bleeding associated with clopidogrel therapy,” said Zheng Ming Chen, M.D., University of Oxford (UK), who presented the findings at the annual meeting of the American College of Cardiology in Orlando (FL, USA) in March 2005.

Other researchers who took part in the study were from Harvard Medical School (Boston, MA, USA), Brigham and Women’s Hospital (also in Boston), and Fuwai Hospital and the Chinese Academy of Medical Sciences (both in Beijing, China). The rates of major bleeding and intracranial hemorrhage were similar in both treatment groups. Clopidogrel (clopidogrel bisulfate) is marketed worldwide by Sanofi-Aventis (Paris, France) and Bristol-Myers Squibb Company (Princeton, NJ, USA) as Plavix and Iscover.