Intracoronary Dipyridamole Reduces the Incidence of Abrupt Vessel Closure Following PTCA: a Prospective Randomised Trial

Overview

Journal Heart

Date 2000 Apr 18

PMID 10768906

Citations 1

Authors

M P Heintzen

U E Heidland

W J Klimek

M Leschke

M Kelm

B Schwartzkopff

E G Vester

C J Michel

B E Strauer

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the effect of intracoronary dipyridamole on the incidence of abrupt vessel closure, myocardial infarction, necessity for bypass grafting, and death following percutaneous transluminal coronary angioplasty (PTCA).

Patients: Patients were randomly allocated to receive either conventional pretreatment (heparin 15 000 IU and aspirin 500 mg intravenously) or additional intracoronary dipyridamole (0.5 mg/kg bodyweight). Dipyridamole was administered in 550 PTCA procedures (455 interventions in men, mean (SD) age 59.2 (8.4) years; 74 acute coronary syndromes), while conventional pretreatment was administered in 544 interventions (444 interventions in men 58.3 (7.9) years old; 81 acute coronary syndromes). In 53 interventions bail out stenting was performed for threatened abrupt vessel closure.

Results: Intracoronary dipyridamole significantly reduced the incidence of abrupt vessel closure (odds ratio 0.42. 95% confidence interval (CI) 0.22 to 0.79). While abrupt vessel closure occurred in 6.1% of interventions following conventional pretreatment, dipyridamole reduced the incidence to 2.5%. Restricting the analysis to balloon angioplasty, this reduction was observed in patients with stable angina (odds ratio 0.49, 95% CI 0.23 to 0.96) as well as in those with acute coronary syndromes (odds ratio 0.29, 95% CI 0.09 to 0.87). Reduction of secondary end points in the dipyridamole treated patients failed to reach significance in the PTCA group.

Conclusions: Intracoronary dipyridamole before PTCA reduces the incidence of abrupt vessel closure following PTCA for stable angina and acute coronary syndromes.

Citing Articles

Dipyridamole with low-dose aspirin augments the infarct size-limiting effects of simvastatin.

Ye Y, Long B, Qian J, Perez-Polo J, Birnbaum Y Cardiovasc Drugs Ther. 2010; 24(5-6):391-9.

PMID: 20640495 PMC: 3051102. DOI: 10.1007/s10557-010-6252-x.

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