Effect on early acute occlusion rate of adjunctive antithrombotic treatment with intravenously administered dipyridamole during percutaneous transluminal coronary angioplasty

Abstract

This study compared the acute occlusion and complication rates within 24 hours of coronary angioplasty in three groups of patients. In group 1, 178 procedures were performed by one operator who administered 30 mg of dipyridamole intravenously over 1 hour, starting immediately before the procedure; in group 2, 200 procedures were performed by the same operator before he administered dipyridamole; and in group 3, 599 procedures were performed during the same time period in the same catheterization laboratory by two other operators who did not administer dipyridamole. All patients received an intravenous bolus of heparin and aspirin. Baseline variables were similar in the three groups. The acute closure rate was 2.8% in group 1, 7.5% in group 2, and 5.2% in group 3 (p < 0.05 between groups 1 and 2); acute thrombosis was observed in 0.6%, 3.5%, and 3% of patients, respectively, in the three groups (p < 0.05 between group 1 and both groups 2 and 3), and acute dissection was noted in 2.2%, 4%, and 2% of patients, respectively (p = not significant). The cumulative rate of acute complications (death, acute myocardial infarction, or emergency coronary bypass surgery) was lower in group 1 (1.7%) than in group 2 (5.5%, p < 0.05) and group 3 (3.5%, p =not significant). Therefore in this restrospective study, adjunctive antithrombotic treatment with intravenously administered dipyridamole resulted in lower acute thrombosis and complication rates during the 24-hour period after the procedure than when heparin and aspirin therapy were used alone.