Barbour M M, Garber C E, Agarwal K C, Malhotra R, Heller G V
Division of Cardiology, Memorial Hospital of Rhode Island, Pawtucket 02860.
Am J Cardiol. 1992 Feb 15;69(5):449-52. doi: 10.1016/0002-9149(92)90983-6.
The effects of oral dipyridamole on exercise performance and anginal symptoms were evaluated in 15 men with stable angina pectoris. In a double-blind, randomized, crossover design, patients received 75 mg of dipyridamole or placebo every 8 hours for 2 weeks in addition to their previously prescribed cardiac medications. Graded exercise tolerance testing was performed twice before randomization, at the end of each treatment period, and after single-blind placebo washout. When compared with baseline tests, the time to onset of 0.1 mV ST-segment depression was similar between dipyridamole and placebo treatments (316 +/- 89 vs 345 +/- 102 seconds, respectively, p = not significant). No significant differences existed between treatments in the peak systolic blood pressure-heart rate product or in the duration of exercise. Angina pectoris occurred during all 3 baseline exercise tests in 7 of the 15 subjects; the time to onset of angina was unchanged by either treatment. Analysis of symptom diaries conducted in 13 patients revealed no significant alteration in reported anginal symptoms during dipyridamole treatment compared with placebo treatment (0.6 +/- 0.9 vs 0.3 +/- 0.4 episodes per week). Ambulatory electrocardiographic monitoring in 12 patients revealed few episodes of ischemia during daily activities with no alteration in frequency of episodes during treatment periods. Plasma concentrations of dipyridamole did not correspond with the outcomes of exercise testing. It is concluded that chronic oral dipyridamole therapy given in its usual clinical dose does not adversely affect exercise performance, daily anginal episodes or ambulatory ischemia in patients receiving concurrent anti-ischemic medication.
在15名稳定型心绞痛男性患者中评估了口服双嘧达莫对运动能力和心绞痛症状的影响。采用双盲、随机、交叉设计，患者在继续服用先前开具的心脏药物的基础上，每8小时服用75毫克双嘧达莫或安慰剂，持续2周。在随机分组前、每个治疗期结束时以及单盲安慰剂洗脱后，进行了两次分级运动耐力测试。与基线测试相比，双嘧达莫和安慰剂治疗组出现0.1 mV ST段压低的时间相似（分别为316±89秒和345±102秒，p =无显著性差异）。治疗组之间在收缩压峰值-心率乘积或运动持续时间方面无显著差异。15名受试者中有7名在所有3次基线运动测试中均出现心绞痛；心绞痛发作时间不受任何一种治疗的影响。对13名患者的症状日记分析显示，与安慰剂治疗相比，双嘧达莫治疗期间报告的心绞痛症状无显著改变（每周0.6±0.9次发作 vs 0.3±0.4次发作）。对12名患者进行的动态心电图监测显示，日常活动期间缺血发作次数很少，治疗期间发作频率无变化。双嘧达莫的血浆浓度与运动测试结果不相关。得出的结论是，以常规临床剂量给予慢性口服双嘧达莫治疗，对同时接受抗缺血药物治疗的患者的运动能力、每日心绞痛发作或动态缺血无不利影响。
