An Approach to the Therapy of Coronary Artery Disease

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Abstract
Dipyridamole is of definite value in the long term treatment of heart disease with ischemia or angina pectoris. After 3 to 6 months of therapy, improvement in all but one of 56 ambulatory patients was observed. The study included 29 men and 27 women, ranging in age from 30 to 92 years, the majority being between 50 and 70. They all had coronary insufficiency. Fifty patients had angina pectoris and 33 had myocardial infarction. In addition, a number of patients had arteriosclerosis, hypertension and other organic disorders. Dipyridamole (Persantin-Geigy), a non-nitrate compound, was given before meals. Eight patients received a daily dose of 75 mg, 46 received 150 mg, and two received 200 mg. Duration of treatment ranged from 3 to 12 months, andaveraged 5 months. All other coronary vasodilators were discontinued except nitroglycerin for acute anginal attacks. Side reactions in 5 patients were mild and transient, but in 1 of these patients the drug was discontinued because of nausea and increased anginal attacks. Results were that 38 patients had an excellent or good response, 17 had a fair response and 1 patient had a poor response. Three patients who showed an excellent response discontinued the drug after 6 months of treatment Two months later these patients continued to do well.