A randomized comparison of trapidil (triazolopyrimidine), a platelet-derived growth factor antagonist, versus aspirin in prevention of angiographic restenosis after coronary artery Palmaz-Schatz stent implantation.
The aim of the study is to assess the safety of trapidil in the setting of coronary stenting and to evaluate its efficacy in reducing angiographic in-stent restenosis. One hundred eighteen patients undergoing Palmaz-Schatz stent implantation were randomly assigned to receive antiplatelet therapy using either aspirin (325 mg/d) or trapidil (400 mg/d), in combination with ticlopidine (500 mg) for the first month. At entry, both groups were comparable with regard to clinical, angiographic, and procedural characteristics. At 6-month angiographic follow-up, >50% restenosis occurred in 15 of 52 lesions (28.8%) of the aspirin group and in 14 of 47 lesions (29.8%) of the trapidil group (P=not significant, NS). At 6-month clinical follow-up, there was no difference in the two groups in the rate of adverse events (2.0% vs. 2.1%, P=NS), medication side effects (4.0% vs. 4.2%, P=NS), and peripheral vascular complications (4.0% vs. 4.2%, P=NS). In conclusion, treatment with trapidil seems to be associated with a similar incidence of stent restenosis and adverse cardiac events as compared to aspirin and could be a valuable alternative to aspirin in the setting of coronary stenting.
Galassi
A R
AR
Institute of Cardiology, Ferrarotto Hospital, University of Catania, Italy. cardioct@mbox.vol.it
Tamburino
C
C
Nicosia
A
A
Russo
G
G
Grassi
R
R
Monaco
A
A
Giuffrida
G
G
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010982:Platelet-Derived Growth Factor / Q000037:antagonists & inhibitors*; D055502:Secondary Prevention; D015607:Stents; D014192:Trapidil / Q000627:therapeutic use*; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D010982:Platelet-Derived Growth Factor; D014192:Trapidil; D001241:Aspirin