Thrombosis Research at Sinai Hospital

Researchers at Sinai Hospital of Baltimore are studying a very small part of the human body with a very big impact.

The Center for Thrombosis Research, part of the Heart Center at Sinai, is conducting groundbreaking research in the area of platelet aggregation, or stickiness. The clumping together of platelets, also referred to as aggregation, is the main reason blood clots develop, causing heart attacks, strokes and the blocking of new coronary artery stents.

Currently, aspirin and PLAVIX are the two major, approved conventional
medications to prevent blood clot formation in people who have coronary artery disease. The Sinai Center for Thrombosis Research, led by Paul A. Gurbel, M.D., questions why some patients continue to form deadly blood clots despite being on these conventional medications. Gurbel, also a member of Hagerstown Heart with a practice at the Heart Center at Sinai, is the hospital’s busiest interventional cardiologist.

In the most recent study performed at the Center for Thrombosis Research, Gurbel and his team found that current aspirin therapy successfully blocks its target at all dosage levels, including 81 mg, 162 mg and 325 mg, in patients with a history of heart disease. The research also showed that aspirin might be just as effective at a lower dose as it is at the maximum dosage in some patients.

As well as studying the effects of aspirin, Gurbel has been leading research on PLAVIX, a commonly prescribed anti-clotting medication. After significant research, Gurbel uncovered that PLAVIX does not work the same in all patients. In fact, up to 30 percent were non-responsive to the standard dose of the drug.

In recent investigations, Gurbel established that patients who did not respond to PLAVIX optimally, frequently had an adverse outcome. In this landmark study, Gurbel and his team clearly demonstrated that high platelet aggregation and less response to PLAVIX after coronary stenting are associated with poor outcomes.

“We are now conducting further research to better understand additional reasons why these deadly blood clots form in some patients, in an effort to continue to improve patient outcomes,”
says Gurbel.

The groundbreaking research being conducted at the Sinai Center for Thrombosis Research may change the current dosing strategy for aspirin and PLAVIX and has had far-reaching effects for patients being treated with coronary stents worldwide. The American Heart Association and the American College of Cardiology have altered some of their practice guidelines as a result of the center’s research findings.

Currently, investigators at the Center for Thrombosis Research are recruiting patients with stable coronary artery disease to measure their platelet reactivity and response to conventional medications, such as aspirin and PLAVIX. Patients who have a poor response to these medications may be asked to participate in studies investigating new anti-clotting medications.

The Center’s research will strongly influence the way doctors treat cardiovascular disease in the future and will likely mandate the universal measurement of the degree of platelet stickiness to ensure that the drugs given are actually doing their job.

For more information about the Center for Thrombosis Research and the Heart Center at Sinai, please call 410-601-WELL (9355).