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2020 SEP 24 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- According to news reporting based on a preprint abstract, our journalists obtained the following [...]

AGGRENOX Boehringer Ingelheim Rx Combination antiplatelet. Dipyridamole 200mg (ext-rel), aspirin 25mg (immediate-release); caps. Indications: To reduce the risk of stroke in patients who have had transient ischemia of the brain [...]

Byline: J.A. Barra, E. Bezon, J. Mansourati, I. Rukbi, P. Mondine, Y. Youssef Abstract: Reimplantation of the right internal thoracic artery, as a free graft, into the left in situ internal thoracic artery (Y procedure) has enabled us to bypass more distant marginal vessels, which was not possible by the bilateral technique alone. This prospective study was aimed at evaluating the clinical state of the patients and the degree of patency of grafts within 16 months of follow-up. All 80 patients who underwent the Y procedure between January 1988 and January 1992 were included. This group represented 10% of the 840 patients having coronary bypass during the same period. A total of 202 coronary anastomoses were performed in this series. Early postoperative (30 days) complications included three deaths (3.75%), eight myocardial infarctions (10%), one case of phrenic nerve paralysis (1.25%), two cases of respiratory failure (2.5%), and six wound infections (7.5%). At 3 months' follow-up, 96% of patients were free of symptoms. During the follow-up period, four patients died of noncardiac causes (lung, pancreatic, and brain cancer and rupture of an abdominal aortic aneurysm). At 1 year, 71 patients were free of symptoms (97%). Sixty-one patients underwent coronary angiography between 12 and 24 months. Six patients with peripheral arterial disease were not suitable for coronary angiography, and six refused to be tested. These 12 patients had normal thallium test results in the bypassed area (stress or dipyridamole test). The patency rate of the left internal thoracic artery was 98.3% (n = 60), occlusion rate 1.6% (n = 1), and incidence of threadlike arteries 4.9% (n = 3). Thus the rate of perfect patency was 93.4%. The patency rate of the right internal thoracic artery as a free graft was 93.4% (n = 57), occlusion rate 6.5% (n = 4), and the incidence of threadlike arteries 8% (n = 5). Thus the rate of perfect patency was 85.2%. A total of 169 anastomoses were studied. The rate of patency of the anastomoses to the left anterior descending coronary artery was 96% (n = 58) and the occlusion rate, 4% (n = 2). The patency rate of sequential anastomoses (side to side) to diagonal arteries was 100% (n = 16). Patency rate of anastomoses to obtuse marginal arteries was 95% (n = 58) and the rate of occlusion, 4.9% (n = 3). The patency rate of anastomoses to the posterior descending artery or distal branches of the right coronary artery was 80% (n = 4/5). We conclude that the Y procedure is a safe technique with an acceptable morbidity and a good patency rate. This procedure can be used when the in situ technique is not possible because of far-reaching distal marginal coronary arteries. (J THORAC CARDIOVASC SURG 1995;109:1042-8) Author Affiliation: Brest, France Article Note: (footnote) [star] From the Centre Hospitalier Universitaire de Brest, Service de Chirurgie thoracique, cardiaque et vasculaire, HA[acute accent]pital Augustin Morvan -- 29609 Brest Cedex, France., [star][star] Read at the Twentieth Annual Meeting of The Western Thoracic Surgical Association, Olympic Valley, Calif., June 22-25, 1994., a Address for reprints: J. A. Barra, MD, Centre Hospitalier Universitaire de Brest, Service de Chirurgie thoracique, cardiaque et vasculaire, HA[acute accent]pital Augustin Morvan -- 29609 Brest Cedex, France., aa 0022-5223/95 $3.00 + 0, acents 12/6/63003

Background. Several studies have provided evidence suggesting that platelets play a key role in tumor metastasis. A number of antiplatelet agents have been used to prevent tumor metastasis in animal models and humans. Antiplatelet agents, dipyridamole (adenosine transport inhibitor), and RA-233 (inhibitor of CAMP PDE) were used to prevent tumor-cell-platelet interactions both in in vitro and in vivo systems; however, the data were not very conclusive. Methods. Our studies used dipyridamole and RA-233 alone and in combination to investigate their effects on human pancreatic tumor cells (RWP-2)-induced platelet aggregation in human blood and on hepatic metastasis in nude mice. To examine effects of dipyridamole and RA-233 on liver metastasis, the tumor cells (RWP-2) were injected intrasplenically in nude mice grouped into control, dipyridamole (8 mg/kg), RA-233 (8 mg/kg), and dipyridamole plus RA-233 (8 mg/kg each). The agents were administered intraperitoneally 1 hour before and 24 hours after the tumor cell injection. Results. When dipyridamole and RA-233 were used alone, only weak to moderate effects were seen on RWP-2 tumor cell-induced platelet aggregation. However, these agents, when combined, strongly inhibited the tumor cell-induced aggregation in human platelet-rich plasma. In tumor metastasis experiments, reductions of approximately 70% in hepatic nodules and 90% in surface area occupied by the tumor were seen with the combination treatment (dipyridamole plus RA-233) as compared with the control group of mice. Conclusions. This study suggests that the combination of dipyridamole and RA-233 provides an effective intervention for the antithrombotic approach to the treatment of cancer metastases. Cancer 1993; 71:2466-71.

The antiplatelet agent dipyridamole is FDA-approved as an adjunct to warfarin for the prevention of thromboembolism in patients receiving prosthetic heart valves. It is also prescribed in several other situations, although data supporting these uses remain equivocal. Dipyridamole does not appear to be superior to aspirin alone in the management of patients with cerebral or coronary artery disease nor in maintaining the patency of autologous grafts. Its role in the management of patients who fail aspirin or other antithrombotic therapy remains to be examined. The drug may offer long-term advantages in the prevention of atherogenesis, but this use also warrants future investigation. Green D, Miller V. The role of dipyridamole in the therapy of vascular disease. Geriatrics 1993; 48(Jan):46-58., The uses for and effectiveness of the antiplatelet inhibitor dipyridamole (Persantine) in the treatment of vascular disease remain elusive.|1~ Clinical data support its FDA-approved indication as an adjunct to coumarin [...]

Controlling risk factors and using antiplatelet therapy can significantly cut the recurrence rate of stroke or transient ischemic attack. But treatments for the secondary prevention of stroke are generally underused. [...]

A comparison was made of the effects of placebo (a treatment with a drug of no pharmacological value), dipyridamole (a drug which opens blood vessels, a vasodilator), and a combination of dipyridamole and aspirin on changes in the platelets and endothelial cells brought about by smoking. Platelets are the blood components responsible for clotting; endothelial cells line the heart and blood vessels, as well as other body cavities. Twelve male habitual smokers with coronary artery disease were treated with these drugs or placebos three times a day for one week before a twenty minute period in which two cigarettes were smoked, after twelve hours of abstinence from smoking. Several changes were noted in the blood of the patients after smoking, including increased nicotine and an increase in carbon dioxide (which displaces oxygen in the blood). Dipyridamole alone or in conjunction with aspirin was not found to be effective in controlling these changes.

Previous studies have shown an increased number of clots (thrombi) and dislodged material in the blood stream of pregnant women with implanted mechanical heart valves. These clots cause obstructions in the flow of blood (embolism). In this study 49 patients were followed from the beginning of pregnancy until after birth. The patients were at varying levels of health. All the patients had proper heart rhythm except four, who had chronic random contraction of the upper heart chambers. All patients were treated with warfarin, an anti-clotting agent, during the first two trimesters as a preventive measure. Forty-one pregnancies proceeded beyond 28 weeks. Of these women, 23 were taken off warfarin and put on another anti-clotting agent, heparin. The substitution was not made in the other 18 women because of premature onset of labor. There were no thrombotic or embolic events or deaths during pregnancy. Bleeding occurred in two patient. Two women developed fluid in their lungs during labor. The average birth weight was low in all the babies. There were nine abortions, seven stillbirths, two infant deaths, and two instances of warfarin- induced abnormal embryo development.

The second European Stroke Prevention Study reports a more effective alternative to monotherapy for hindering another transient ischemic attack or stroke in first-time patients. A new method called combination antiplatelet therapy utilizes the curing effects of dipyridamole and aspirin. A supporting study using the combined antiplatelet agents showed a lessening of reattack by 37%., Source: American Heart Association's 21st International Joint Conference on Stroke and Cerebral Circulation, San Antonio, TX In patients who have suffered a transient ischemic attack (TIA) or stroke, combination antiplatelet [...]

Wahlgren NG. Critical analysis of the combination of dipyridamole plus acetylsalicylic acid versus acetylsalicylic acid alone in the secondary prevention of stroke. Int J Clin Pract 1998; 97(suppl):3-6. Clinical question [...]