Efficacy of combination antiplatelet therapy and nicardipine for chronic cerebral infarction.
To prevent recurrence of cerebral infarction (CI), the efficacy of antiplatelet therapy, when used in combination with a calcium antagonist, was examined. The study subjects were 57 chronic CI patients (40 men, 17 women; mean age, 68.5 years) who experienced either CI or its recurrence more than 3 months before the start of the study. They were randomly allocated into one of the following four groups for the 8-week study; group A--ticlopidine hydrochloride 200 mg once daily and nicardipine hydrochloride 20 mg three times daily (TID); group B--ticlopidine hydrochloride 200 mg once daily; group C--aspirin 81 mg once daily and nicardipine hydrochloride 20 mg TID; or group D--aspirin 81 mg once daily. Platelet aggregation was measured before treatment and 4 and 8 weeks after the initiation of each therapy by using adenosine diphosphate (ADP) (2 microM and 0.5 microM) and collagen (2 micrograms/mL), and evaluated in terms of percent maximum platelet aggregation. Results showed significant suppression of 2.0 microM ADP platelet aggregation in groups A, B, and C. At 0.5-microM ADP, only groups A and B showed significant platelet aggregation suppression. All groups showed significant suppression of collagen platelet aggregation. In comparing single therapy with combination therapy, groups A and B were not significantly different from one another after 4 or 8 weeks in 2-microM ADP or collagen platelet aggregation suppression. In contrast, group C had significantly greater suppression of both 2-microM ADP and collagen aggregations compared with group D. In conclusion, nicardipine hydrochloride administration with aspirin may be a useful alternative therapy for the prevention of CI recurrence.
Nomura
H
H
Department of Internal Medicine, Shin-Kokura Hospital, Kitakyushu, Japan.
Morita
C
C
Kuwano
S
S
Eto
H
H
Goto
H
H
Kuwahara
H
H
D000244:Adenosine Diphosphate / Q000037:antagonists & inhibitors / Q000494:pharmacology; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002544:Cerebral Infarction / Q000097:blood / Q000188:drug therapy*; D002908:Chronic Disease; D003094:Collagen / Q000037:antagonists & inhibitors / Q000494:pharmacology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009529:Nicardipine / Q000627:therapeutic use*; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013988:Ticlopidine / Q000627:therapeutic use
D002121:Calcium Channel Blockers; D010975:Platelet Aggregation Inhibitors; D000244:Adenosine Diphosphate; D003094:Collagen; D009529:Nicardipine; D013988:Ticlopidine; D001241:Aspirin