DIPYRIDAMOLE SUMMARY
Dipyridamole is a platelet inhibitor chemically described as 2,2',2'',2'''-[(4,8-Dipiperidinopyrimido[5,4- d ]pyrimidine-2,6-diyl)dinitrilo]-tetraethanol.
Dipyridamole tablets are indicated as an adjunct to coumarin anticoagulants in the prevention of postoperative thromboembolic complications of cardiac valve replacement.
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NEWS HIGHLIGHTS
Published Studies Related to Dipyridamole
Clopidogrel versus dipyridamole in addition to aspirin in reducing embolization detected with ambulatory transcranial Doppler: a randomized trial. [2011.03] BACKGROUND AND PURPOSE: After stroke and transient ischemic attack there is a high early risk of recurrent stroke, particularly in large artery disease. It has been suggested more intensive antiplatelet regimens are required, but trial data are lacking. Treatment efficacy can be evaluated using transcranial Doppler detection of embolic signals. Ambulatory transcranial Doppler has recently been developed; prolonged recording may reduce subject numbers required to determine therapeutic efficacy. In a randomized trial (ISRCTN68019845) with blinded end point evaluation, we determined whether treatment with dipyridamole or clopidogrel, in addition to aspirin, was more effective at reducing embolization... CONCLUSIONS: Both dipyridamole and clopidogrel reduced embolization to a similar extent. Embolic signals are strong predictors of future stroke rate in this patient group. Our results suggest these 2 treatment regimens have similar efficacy in early secondary prevention of stroke, although this now needs testing in large Phase III trials.
The Japanese aggrenox (extended-release dipyridamole plus aspirin) stroke prevention versus aspirin programme (JASAP) study: a randomized, double-blind, controlled trial. [2011] BACKGROUND: Despite improvements in treatment, stroke still carries a high death toll and disability in Asia. Extended-release dipyridamole (ER-DP) plus acetylsalicylic acid (ASA) has consistently been shown to be superior over conventional platelet inhibition by ASA. ER-DP plus ASA is well established in the secondary prevention of stroke in a lot of countries including the USA and Europe. DP has an established benefit in the treatment of heart disease in Japan; however, for the prevention of stroke, the fixed-dose combination of ER-DP plus ASA has only been investigated in a small number of patients in Japan... CONCLUSIONS: The results of the study are inconclusive. Noninferiority of ER-DP plus ASA versus ASA could not be established, a difference between treatments could not be shown for the primary end point. Possible reasons for this result include a small sample size, low event rates and too short a treatment duration (ClinicalTrials. gov number, NCT00311402). Copyright (c) 2011 S. Karger AG, Basel.
Clopidogrel versus dipyridamole in addition to aspirin in reducing embolization
detected with ambulatory transcranial Doppler: a randomized trial. [2011] clopidogrel, in addition to aspirin, was more effective at reducing embolization... CONCLUSIONS: Both dipyridamole and clopidogrel reduced embolization to a similar
Dipyridamole versus verapamil for treatment of no-reflow during primary angioplasty. [2010.11.15] CONCLUSIONS: Dipyridamole is a safe and effective first-line drug for treatment of no-reflow. Dipyridamole can also be successfully used in patients with incomplete response to verapamil. Copyright (c) 2010 Wiley-Liss, Inc.
Fourteen-year follow-up from CABADAS: vitamin K antagonists or dipyridamole not superior to aspirin. [2010.11] BACKGROUND: Secondary prophylaxis using aspirin is standard of care after coronary artery bypass graft surgery. Limited data are available for long-term results. We evaluated the effect of aspirin, aspirin with dipyridamole, and vitamin K antagonists (VKA) on 14-year clinical outcome of patients included in the Prevention of Coronary Artery Bypass Graft Occlusion by Aspirin, Dipyridamole, and Acenocoumarol/Phenprocoumon Study (CABADAS)... CONCLUSIONS: This study with 14-year clinical outcome provides further evidence for the use of aspirin as secondary prophylaxis after coronary artery bypass graft surgery. Copyright (c) 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Clinical Trials Related to Dipyridamole
Dipyridamole for Immune Activation in HIV [Recruiting]
The purpose of this study is to determine if Dipyridamole (DP) will decrease inflammation in
HIV-1-infected individuals who are already on antiretroviral treatment and have a low viral
load.
The Vascular Biology of Dipyridamole in Peripheral Arterial Disease (PAD) [Terminated]
This research study will evaluate the effects of aspirin and dipyridamole alone and in
combination on the blood flow in the vessels of the legs. We will examine how these
medications are able to inhibit the clotting of platelets in the vessels of patients with
PAD, and thereby affect the blood flow in the legs. Platelets are cells in the blood that
have the ability to adhere to each other to form clots.
Does a Seven Day Treatment With Dipyridamole Induce Protection Against Ischemia-Reperfusion Injury? [Completed]
This study is performed to determine whether a seven day treatment with dipyridamole (slow
release, 200mg twice daily) can induce a protective effect against ischemia-reperfusion
injury, after ischemic exercise of the non-dominant forearm in healthy volunteers.
The Effects of Oral Dipyridamole Treatment on the Innate Immune Response During Human Endotoxemia [Completed]
During sepsis and septic shock the immune response can be overwhelming leading to excessive
tissue damage, organ failure and death. Ideally, the inflammatory response is modulated
leading to both adequate protection to invading pathogens as well as limitation of an
exuberant immune response. In the last few years adenosine is proposed to have a central
role in the modulation of inflammation. In unfavorable conditions such as hypoxia, ischemia
or inflammation adenosine is quickly up-regulated; with concentrations up to tenfold in
septic patients. Many animal studies have shown that adenosine is able to attenuate the
inflammatory response and decrease mortality rates. Therefore, pharmacological elevation of
the adenosine concentration is an potential target to attenuate inflammation and limit organ
injury. Dipyridamole, an adenosine re-uptake inhibitor is able to increase the adenosine
concentration and limit ischemia-reperfusion injury. In order to study the effects of
dipyridamole on the inflammatory response we aim to use the so called human endotoxemia
model. This model permits elucidation of key players in the immune response to a gram
negative stimulus in vivo, therefore serving as a useful tool to investigate potential novel
therapeutic strategies in a standardized setting.
Can Dipyridamole Induce Protection Against Ischemia and Reperfusion Injury in Patients Undergoing Elective Coronary Artery Bypass Grafting (CABG)? [Completed]
Rationale:
Due to western lifestyle human coronary arteries are prone to develop atherosclerotic
plaques. Hence the heart is an important target organ for atherothrombotic complications:
myocardial ischemia, arrhythmias, myocardial infarction and heart failure. To alleviate
symptoms and decrease mortality in these patients, myocardial revascularisation is
recommended. Coronary artery bypass grafting (CABG) is indicated in patients with severe
atherosclerotic disease of all three coronary arteries or the left main stem coronary
artery. Cardiac ischemia and reperfusion injury during CABG is inevitable and jointly
accountable for complications that occur after CABG (e. g. death, myocardial infarction,
arrhythmias, stroke, or renal complications). Dipyridamole has been shown to reduce ischemia
reperfusion injury in healthy volunteers using an intermediate endpoint and may prevent
cardiovascular death or event in secondary prevention after cerebrovascular disease. The
investigators hypothesise that oral pre-treatment with dipyridamole can increase cardiac
tissue tolerance against ischemia and reperfusion injury due to CABG. The investigators
expect lower troponin-I release in patients who were pretreated with dipyridamole.
Objective: To study the effect of oral pretreatment with dipyridamole on high sensitivity
(HS)-troponin-I release after CABG. Secondary objectives are whether oral pretreatment with
dipyridamole reduces postoperative CABG arrhythmias, prolonged inotropic support, and
duration of Intensive Care-stay. Further secondary endpoints are the effects of dipyridamole
pretreatment on renal injury and post-ischemic recovery of contractile function (measured
ex-vivo).
Hypothesis:
The investigators hypothesize that oral pre-treatment with dipyridamole can increase cardiac
tissue tolerance against ischemia and reperfusion injury. The investigators expect lower
HS-troponin-I release in patients who were pretreated with dipyridamole. Additionally the
investigators expect the incidence of arrhythmias, need for prolonged inotropic support
(longer than 24 hours postoperative) to be decreased in pretreated patients.
Reports of Suspected Dipyridamole Side Effects
Cerebrovascular Accident (12),
Abdominal Pain (6),
Gastrointestinal Haemorrhage (6),
Myalgia (6),
Cardiac Tamponade (5),
Renal Disorder (5),
Shock (5),
LOW Birth Weight Baby (4),
Premature Baby (4),
Pyrexia (3), more >>
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Page last updated: 2013-02-10
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