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Plavix Can Help Cut Death Risk in Certain Heart Patients

Rating

2 Star

Plavix Can Help Cut Death Risk in Certain Heart Patients

Our Review Summary

 Few studies have examined the possible benefit or harm of clopidogrel in heart failure patients.  This observational study does not provide definitive evidence that the benefit exceeds the risks. In fact, no mention of risk is mentioned in the article.  It suggests possible benefit but that benefit may be because of physicians using their judgment to decide that sicker patients should not receive clopidogrel, so the improved survival observed in patients taking clopidogrel may simply be due to differences in how doctors selected patients for treatment or not.  It is not clear if the study attempted to "adjust" for differences in the study populations using statistical methods. 

 

Why This Matters

It is overly enthusiastic to say that this drug ‘can’ cut death risk in heart failure patients.  The story is misleading because it failed to report on the study nuances that prevent conclusions from being drawn at this time.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

 There was no discussion about the cost of this drug.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story provided absolute numbers for two categories of patients who had had heart attacks and did not have angioplasty.  In the first group, the chance of survival for those with heart failure at 18 months appeared to be higher for those that took Plavix than those who did not.  In the second group, at two years, there did not appear to be a difference in survival between those without heart failure whether they took the drug or not. 

While presenting the reader with the quantitative results, the story neglected to indicate if the differences observed were statistically significant.

It would also have been helpful to note the number needed to treat:  37 heart failure patients would need to be treated for a year in order for one life to be saved.  For non-heart-failure patients, 667 patients would need to take the drug for a year in order for one life to be saved.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

 There was no discussion about any potential harms associated with the use of plavix.  

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

 The story did not do an adequate job in describing the quality of the evidence discussed.  The story just assumed that the reason those receiving Plavix fared better was because of the drug.  However – this was a non-randomized study so that patients who were taking Plavix could have differed from those that did not.  They may have been healthier so the lower risk of dying might simply be due to this rather than from the addition of the medication.

Does the story commit disease-mongering?

Not Applicable

 Not applicable because there was really no discussion of heart failure incidence or seriousness.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

 The story quotes an editorial writer but did not appear to go beyond a news release for interpretation of the study results. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

 There was no discussion about the impact other medications in the same class as Plavix have in the populations studied.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

 Plavix (clopidogrel) is a medication already on the market.  While the story did not state this explicitly, it was implied.

Does the story establish the true novelty of the approach?

Satisfactory

The story stated that "the value of clopidogrel (Plavix) to treat heart failure patients has been long debated."

Does the story appear to rely solely or largely on a news release?

Not Satisfactory

The story states that its sole source was a news release from the American College of Cardiology.

Total Score: 3 of 9 Satisfactory

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