Effect of Thromboxane A 2 Blockade on Clinical Outcome and Restenosis After Successful Coronary Angioplasty

• DOI: 10.1161/01.cir.92.11.3194
• Publication Date: 2012-06-12T00:34:42Z
• Authors: Michael P. Savage; Sheldon Goldberg; Alfred A. Bove; Ezra Deutsch; George Vetrovec; Robert G. Macdonald; Theodore Bass; James R. Margolis; Hall B. Whitworth; Andrew Taussig; John W. Hirshfeld; Michael Cowley; James A. Hill; Ronald G. Marks; David L. Fischman; Eileen Handberg; Howard Herrmann; Carl J. Pepine
• Keywords: Unstable angina

Background Antithromboxane therapy with aspirin reduces acute procedural complications of coronary angioplasty (PTCA) but has not been shown to prevent restenosis. The effect chronic on long-term clinical events after PTCA is unknown, and the utility more specific antithromboxane agents uncertain. goal this study was assess effects (a nonselective inhibitor thromboxane A 2 synthesis) sulotroban selective blocker receptor) late restenosis PTCA. Methods Results Patients (n=752) were randomly assigned (325 mg daily), (800 QID), or placebo, started within 6 hours before continued for months. primary outcome failure at months successful PTCA, defined as (1) death, (2) myocardial infarction, (3) associated recurrent angina need repeat revascularization. Neither active treatment differed significantly from placebo in rate angiographic restenosis: 39% (73 188) aspirin-assigned group, 53% (100 189) 43% (85 196) group. In contrast, improved comparison ( P =.046) =.006). Clinical occurred 30% (49 162) 44% 166) 41% (71 175) Myocardial infarction reduced by therapy: 1.2% 1.8% 5.7% group =.030). Conclusions Thromboxane blockade protects against ischemic even though reduced. While both occurrence overall appears superior compared sulotroban. Therefore, should be least angioplasty.