Heart Attack Squared

On our way to the office we stumbled on things you really should be aware of while getting away from stories that aren't as important as you might think. The story was that a new drug that might be a better way to prevent a second heart attack in some patients and the chances looked good. The study was presented at an European Society of Cardiology (ESC) and published yesterday in the New England Journal of Medicine. We went to NEJM and couldn't find it searching by the European Society of Cardiology or the University of Sheffeld which was conducting the research and we kept finding shiny articles that did appeal to us though we couldn't find the article on the drug. Then we searched for PLATO (the study's code name) and there were an editorial and an article. The editorial was free hence linked here. And the bad news from the editorial was: "The whole story concerning the adverse effects of ticagrelor may require evaluation in a much larger number of patients, something that may be beyond the capacity of a randomized trial. We should carefully monitor patients receiving this drug to establish the overall impact of its side effects. Finally, efforts to develop new effective and safe antithrombotic drug regimens should not be discouraged by the perception that an increase in antithrombotic efficacy is necessarily associated with a higher risk of bleeding."

Reading the abstract however gives you a different conclusion altogether: "In conclusion, in patients who had an acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor, as compared with clopidogrel, significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke, without an increase in the rate of overall major bleeding but with an increase in the rate of non–procedure-related bleeding."

You might die from standard treatment using current drugs but this new drug will kill less people so it's better! So the choice is change your lifestyle or take drugs that might kill you and don't change a thing? Hum? Hard choice to make.