Effect of dipyridamole on myocardial reperfusion injury: A double-blind randomized controlled trial in patients undergoing elective coronary artery bypass surgery

Clin Pharmacol Ther. 2016 Apr;99(4):381-9. doi: 10.1002/cpt.106. Epub 2015 Oct 22.

Abstract

Dipyridamole reduces reperfusion-injury in preclinical trials and may be beneficial in patients undergoing coronary angioplasty, but its effect on patients undergoing coronary artery bypass grafting (CABG) is unknown. We hypothesized that dipyridamole limits myocardial reperfusion-injury in patients undergoing CABG. The trial design was a double-blind trial randomizing between pretreatment with dipyridamole or placebo. In all, 94 patients undergoing elective on-pump CABG were recruited between February 2010 and June 2012. The primary endpoint was plasma high-sensitive (hs-) troponin-I at 6, 12, and 24 hours after reperfusion. Secondary endpoints were the occurrence of bleeding, arrhythmias, need for inotropic support, and intensive care unit length of stay. Finally, 79 patients (33 dipyridamole) were included in the per-protocol analysis. Dipyridamole did not significantly affect postoperative hs-troponin-I (change in plasma hs-troponin I -3% [95% confidence interval -23% to 36%]; P > 0.1). Secondary endpoints did not differ between groups. Dipyridamole prior to CABG does not significantly reduce postoperative hs-troponin release.

Trial registration: ClinicalTrials.gov NCT01295567.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AMP Deaminase / genetics
  • AMP Deaminase / metabolism
  • Aged
  • Biomarkers / blood
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Coronary Artery Bypass / adverse effects*
  • Dipyridamole / adverse effects
  • Dipyridamole / therapeutic use*
  • Double-Blind Method
  • Elective Surgical Procedures
  • Female
  • Genotype
  • Humans
  • Inflammation Mediators / blood
  • Male
  • Middle Aged
  • Myocardial Reperfusion Injury / blood
  • Myocardial Reperfusion Injury / diagnosis
  • Myocardial Reperfusion Injury / etiology
  • Myocardial Reperfusion Injury / prevention & control*
  • Netherlands
  • Pharmacogenetics
  • Phenotype
  • Time Factors
  • Treatment Outcome
  • Troponin I / blood
  • Up-Regulation

Substances

  • Biomarkers
  • Cardiovascular Agents
  • Inflammation Mediators
  • Troponin I
  • Dipyridamole
  • AMP Deaminase

Associated data

  • ClinicalTrials.gov/NCT01295567