Friday, June 09, 2006

Coumadin Beats Aspirin+Plavix

Once again, the anticoagulant warfarin (Coumadin) demonstrated clear superiority to even Aspirin and clopidogrel (Plavix) therapy in a study of 3334 patients as reported in today's Lancet:

The study was stopped early because of clear evidence of superiority of oral anticoagulation therapy. There were 165 primary events in patients on oral anticoagulation therapy (annual risk 3·93%) and 234 in those on clopidogrel plus aspirin (annual risk 5·60%; relative risk 1·44 (1·18–1.76; p=0.0003). Patients on oral anticoagulation therapy who were already receiving this treatment at study entry had a trend towards a greater reduction in vascular events (relative risk 1·50, 95% CI 1·19–1·89) and a significantly (p=0·03 for interaction) lower risk of major bleeding with oral anticoagulation therapy (1.30; 0.94–1.79) than patients not on this treatment at study entry (1·27, 0·85–1·89 and 0·59, 0·32–1·08, respectively).

There continues to be no easy way out of those finger-sticks for blood-thinning levels (or INR's) yet -


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