Chronic stable angina treatment dipyridamole
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Chronic stable angina Microchapters | ||
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Differentiating Chronic Stable Angina from Acute Coronary Syndromes | ||
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Diagnosis | ||
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Alternative Therapies for Refractory Angina | ||
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Discharge Care | ||
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Guidelines for Asymptomatic Patients | ||
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Risk calculators and risk factors for Chronic stable angina treatment dipyridamole | ||
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Phone:617-632-7753; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]; John Fani Srour, M.D.; Jinhui Wu, M.D.; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
Dipyridamole is a pyrimidopyrimidine derivative with poor anti-thrombotic efficacy and therefore not recommended for anti-platelet therapy in patients with chronic stable angina.[1] Dipyridamole may also exacerbate anginal symptoms due to coronary steal phenomenon.[2]
Mechanisms of Benefit
- Dipyridamole is a pyrimido-pyrimidine derivative.
- Dipyridamole exerts vasodilator effects on coronary resistance vessels.
Contraindications
Dipyridamole enhances exercise-induced myocardial ischemia even the usual oral dosage and hence it not used as an anti-platelet agent in patients with stable angina.
Adverse Effects
- Exercise induced myocardial ischemia
- Exacerbation of anginal symptoms
- Hypotension
- Headache
- Bronchospasm
Supportive Trial Data
In a post hoc analysis that investigated cardiac events in patients with coronary heart disease or MI at study entry, dipyridamole therapy did not result in a higher number of cardiac events such as angina pectoris, MI or death from all causes. [3]
1999 ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina (DO NOT EDIT) [4]
Dipyramidole (DO NOT EDIT)[4]
| Class III (No Benefit) |
| "1. Dipyridamole. (Level of Evidence: B) " |
References
- ↑ Antithrombotic Trialists' Collaboration (2002) Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324 (7329):71-86. PMID: 11786451
- ↑ Kaufmann PA, Mandinov L, Seiler C, Hess OM (2000) Impact of exercise-induced coronary vasomotion on anti-ischemic therapy. Coron Artery Dis 11 (4):363-9. PMID: 10860181
- ↑ Diener HC, Darius H, Bertrand-Hardy JM, Humphreys M, European Stroke Prevention Study 2 (2001) Cardiac safety in the European Stroke Prevention Study 2 (ESPS2). Int J Clin Pract 55 (3):162-3. PMID: 11351768
- ↑ 4.0 4.1 Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina). Circulation 99 (21):2829-48. [1] PMID: 10351980