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Friday, 28 January, 2000, 02:59 GMT
Aspirin 'as good as heart drug'

heart attack Aspirin as effective as specialist drugs in treating heart patients

A new drug is no more effective than aspirin in preventing heart attacks, scientists claim.

They found that people were as likely to be prevented from having heart attacks using aspirin as they were taking a potentially far more expensive drug called sibrafiban.

People were also more likely to suffer bleeding with high doses of sibrafiban, according to the study of over 9,000 patients.

Aspirin is one of the best buys in heart disease because it is effective and it is so cheap
Dr Howard Robson
The international study, known as the Symphony Trial, studied the effect of sibrafiban - one of a class of drugs called glycoprotein IIb/IIIa receptor antagonists - on patients in 33 countries.

Aspirin is a weak inhibitor of platelet aggregation, the process that leads to formation of clots in the coronary blood vessels and can cause heart attack and death.

The patients were randomly given aspirin or low or high doses of sibrafiban and their cardiac state was assessed over 90 days.

'No additional benefit'

Publishing their results in The Lancet medical journal, the scientific team led by Dr Kristin Newby at the Duke Clinical Research Institute of North Carolina, said sibrafiban "showed no additional benefit over aspirin" in preventing cardiac arrest.

The drug is still under development by drug firm Hoffman-La Roche and is not yet on the market.

The Symphony Trial report added: "Given the substantial benefit of aspirin alone, and its low cost and lower bleeding risk, none of the completed studies provide evidence that would justify use of oral glycoprotein IIb/IIIa inhibitor."

Christopher Heeschen and Christian Hamm, of the department of cardiovascular medicine at Stanford University, California, also writing in The Lancet, said there are three possible reasons for the lack of benefit of sibrafiban.

It may be that aspirin's success could be due to some of its other properties, such as anti-inflammatory effects, they said.

Also, the safe and effective levels of drugs such as sibrafiban are not yet known, and the patients included in the study may not have been high risk, so the drug's effect would be small, they added.

But Dr Howard Robson, a consultant in general medicine at Cumberland Hospital, who has been involved in research comparing aspirin and oral inhibitors, said: "Aspirin is one of the best buys in heart disease because it is effective and it is so cheap.

"Anybody with coronary heart disease would have to think carefully about why they should not be on aspirin, rather than the other way around."

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