Effectiveness of a novel serotonin blocker, sarpogrelate, for patients with angina pectoris.
BACKGROUND
We have recently demonstrated that a single oral administration of sarpogrelate, a 5-HT(2A) receptor antagonist, may improve exercise capacity in anginal patients with well-developed collaterals. The aim of the current study was to investigate the effectiveness of 2-week treatment with sarpogrelate on anginal symptoms and exercise capacity in anginal patients.


METHODS
A treadmill exercise test was repeated after a 2-week period with or without sarpogrelate (100 mg 3 times a day) in 20 patients with angiographically proven stable angina. Anginal symptoms and daily physical activity by the specific activity scale (SAS) were also evaluated.


RESULTS
Treatment with sarpogrelate significantly increased the SAS score and prolonged exercise time to the onset of 0.1-mV ST depression. When data were analyzed in a subgroup of patients (n = 8) with well-developed collaterals, the treatment with sarpogrelate decreased the number of anginal attacks (control vs sarpogrelate, 3.0 +/- 2.8 vs 0.9 +/- 1.1/2 weeks, P <.05), increased the SAS score (5.2 +/- 1.6 vs 6.2 +/- 1.3 METS, P <.05), and increased the time to the onset of 0.1-mV ST depression (235 +/- 84 vs 295 +/- 127 seconds, P <.05). In addition, the double product at the onset of 0.1-mV ST depression increased by 15% (P <.05) after sarpogrelate. In contrast, all parameters were not significantly changed after sarpogrelate treatment in patients (n = 12) without well-developed collaterals.


CONCLUSIONS
These findings indicate the therapeutic effectiveness of sarpogrelate for anginal patients, especially for patients with well-developed collaterals.
Division of Cardiology, First Department of Internal Medicine, Tottori University, Tottori, Japan.
Toru
T
Kinugawa
Masatoshi
M
Fujita
Jong-Dae
JD
Lee
Hitoshi
H
Nakajima
Hiroyuki
H
Hanada
Shoichi
S
Miyamoto
D000368:Aged; D000787:Angina Pectoris / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology*; D002908:Chronic Disease; D003097:Collateral Circulation; D017023:Coronary Angiography; D004359:Drug Therapy, Combination; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D013386:Succinates / Q000627:therapeutic use*; D016896:Treatment Outcome
D012702:Serotonin Antagonists; D013386:Succinates; C064294:sarpogrelate; D005996:Nitroglycerin