[Thallium-201 myocardial perfusion imaging after aortocoronary bypass in patients treated with sulodexide or ASA-dipyridamole].
The aim of this investigation was to compare the preventive effect of sulodexide, a glycosaminoglycan drug, tested versus ASA-dipyridamole association, on the occlusion of venous aortocoronary bypass. A group A of 23 patients, for a total of 22 anastomosis with internal mammary artery and 46 venous bypass, was treated with sulodexide 500 USL/day. A group B of 18 patients for a total of 19 anastomosis with internal mammary artery and 33 venous bypass, was treated with ASA-dipyridamole 300 mg + 400 mg/day. Three and 9 months after surgery, all patients underwent thallium-201 myocardial perfusion imaging, associated with ergometric test. At the first control after 3 months, reversible perfusion defect in one or more myocardial segments was observed in 8 patients of group A and 3 patients of group B (2 A patients and 1 B patient in non revascularized myocardial segments); after 9 months, reversible perfusion defects were observed in 4 A patients and in 4 B patients. After 3 months, non reversible perfusion defect imaging in non infarcted myocardial segments was observed in 2 A patients and in 1 B patient; after 9 months, in 1 patient of both groups. This research shows higher incidence, at first control after 3 months, of ischemic reversible perfusion defects in patients treated with sulodexide, with an evident improvement in some patients recontrolled after 9 months. At the last control after 9 months, the scintigraphic findings showed similar evidence of perfusion defects in both groups treated with sulodexide or ASA-dipyridamole, with concordant angiographic findings (78.6%). Our preliminary results are encouraging and suggest further widespread studies on sulodexide therapy.
Astorri
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E
Cattedra di Cardiologia, Università degli Studi di Parma.
Saccani
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S
Beghi
C
C
Raise
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G
D001157:Arterial Occlusive Diseases / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004176:Dipyridamole / Q000627:therapeutic use*; D004341:Drug Evaluation; D005260:Female; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D015425:Myocardial Reperfusion; D009204:Myocardial Revascularization; D011183:Postoperative Complications; D013794:Thallium Radioisotopes; D014665:Vasodilator Agents / Q000627:therapeutic use
D006025:Glycosaminoglycans; D000960:Hypolipidemic Agents; D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D004176:Dipyridamole; C007858:glucuronyl glucosamine glycan sulfate
Analisi con tallio-201 del quadro perfusionale miocardico dopo bypass aortocoronarico in pazienti trattati con sulodexide ed in pazienti trattati con ASA-dipiridamolo.