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Early Clopidogrel After MI Cuts Risk of Death, Repeat MI

COMMIT study of 45,852 with recent myocardial infarction shows mortality down by 7%

FRIDAY, Nov. 4 (HealthDay News) -- Clopidogrel could reduce the number of deaths from myocardial infarction if used for early intervention, according to the results of the Clopidogrel and Metoprolol in Myocardial Infarction Trial (COMMIT) mega-study published in this week's issue of The Lancet. Adding clopidogrel to standard aspirin and fibrinolytic therapy "should be considered routinely," the authors add.

Zhengming Chen, M.D., of the University of Oxford, U.K., and colleagues report the findings of the randomized, placebo-controlled COMMIT study that included 45,852 patients from 1,250 hospitals, with suspected acute myocardial infarction -- most with ST-segment elevation. Patients were randomized to 75 mg clopidogrel daily or placebo, in addition to aspirin, for four weeks in the hospital or until discharge.

The authors found that clopidogrel reduced the number of deaths by 7% and reduced the combined outcome of death, repeat myocardial infarction, and stroke by 9% compared with placebo. The treatment also reduced the number of myocardial infarctions within the treatment period by 14%. There were no excessive bleeding complications reported.

"If early clopidogrel therapy was given in hospital to just 1 million of the 10 million patients who have an MI every year, then it would, on present evidence, prevent about 5000 deaths and 5000 non-fatal reinfarctions and strokes," the authors conclude.

The study was funded by the drugmakers Bristol-Myers Squibb, Sanofi-Aventis and AstraZeneca.

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