Dipyridamole in chronic stable angina pectoris; a randomized, double blind, placebo-controlled, parallel group study

Area of Science:

• Cardiology
• Pharmacology

Background:

• Oral dipyridamole increases endogenous adenosine, promoting angiogenesis in hypoxic conditions.
• Previous meta-analyses suggest dipyridamole benefits angina pectoris, particularly with prolonged use.

Purpose of the Study:

• To evaluate the efficacy and safety of oral dipyridamole in patients with chronic stable angina.
• To conduct a large-scale, international, randomized, placebo-controlled study.

Main Methods:

• 400 patients with chronic stable angina were randomized to modified-release dipyridamole (200 mg b.i.d.) or placebo for 24 weeks.
• Treatment was an add-on to conventional therapy, followed by a 4-week monotherapy phase after withdrawing standard medications.

Main Results:

• Serious adverse events were similar between dipyridamole (7.6%) and placebo (6.0%).
• Efficacy parameters, including treadmill exercise test duration and time to ST depression, were largely comparable between groups.
• A beneficial effect on time to angina was observed in favor of dipyridamole at week 8 for patients with lower exercise tolerance.

Conclusions:

• Oral dipyridamole is safe and well-tolerated in patients with chronic stable angina on background antianginal medication.
• Dipyridamole demonstrated comparable antianginal and anti-ischemic efficacy to placebo.
• A specific benefit in time to ischemia was noted for patients with lower baseline exercise tolerance.