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PubMed1985

[Assessment of coronary stenosis by myocardial scintigraphy with thallium-201 after dipyridamol infusion].

After a 4 minute i.v. dipyridamole infusion (0.14 mg/Kg/min) serial Thallium-201 scans were obtained in 45 patients, without myocardial necrosis, undergoing coronarography. Twelve patients had effort angina, 6 rest angina, 14 effort associated with rest angina, 13 had atypical chest pain. Thirty-two patients had a 50% or greater stenosis of 1 or more coronary artery (8 had three vessels disease, 7 two vessels, 17 one vessel); 13 patients had no significant coronary stenosis ("control group"). The test induced electrocardiographic signs of ischemia in 18 patients, all with significant coronary stenosis, 15 of them experienced angina too. Sensitivity of Thallium-201 for detecting coronary artery stenosis was 94% (30 of 32) and specificity was 85% (11 of 13). In the group of the 17 patients with one vessel disease we obtained a sensitivity and specificity of 100% (17 of 17). We conclude that Thallium-201 myocardial imaging after pharmacologic vasodilatation with dipyridamole is a highly sensitive and specific test for detecting coronary artery stenoses without necessary overt ischemia. In fact dipyridamole, as consequence of its important coronary vasodilatation, produces differences in myocardial perfusion with relative perfusion defects detectable with Thallium-201 imaging.

Adult↗
PubMed1985

[Use of myocardial scintigraphy with 201T1 in combination with the dipyridamole test in patients with ischemic heart disease].

Possible diagnostic use of myocardial 201T1-scintigraphy combined with the dipyridamole test in coronary patients is described. Twenty-six patients were investigated. Coronarography showed atherosclerotic lesions of coronary arteries in 12. The dipyridamole test was positive in all patients with affected coronary arteries, as evidenced by myocardial 201T1-scintigraphy. In the patients with intact coronary arteries, myocardial 201T1-scintigraphy combined with the dipyridamole test was negative in 9 cases and positive in 3. The study demonstrates high sensitivity of the method described.

Adult↗
PubMed1982

Antiviral action of dipyridamole and its derivatives against influenza virus A.

Dipyridamole proved to be active against influenza viruses A/England 42/72, A/Bangkok 1/79 and A/fowl plague (FPV). The antiviral activities assayed by various methods varied from 90-99 per cent. No inhibition was found against influenza virus B/Leningrad 235/74 in vitro. Three dipyridamole derivatives were significantly active in tissue cultures against influenza virus A/England 42/72 and A/FPV. In white mice infected with influenza virus A/England 42/72 dipyridamole administered orally showed a protection rate of 62.5 per cent.

Animals↗
PubMed1983

Biochemical effects of dipyridamole on purine overproduction and excretion by mutant murine T-lymphoblasts.

A mutant murine T-cell line which overproduces purines and excretes massive quantities of inosine into the culture medium has served as a cell culture model for overproduction hyperuricemia (Ullman, B., Wormsted, M. A., Cohen, M. B., and Martin, D. W., Jr. (1982) Proc. Natl. Acad. Sci. U. S. A. 79, 5127-5131). Incubation of these cells with micromolar concentrations of dipyridamole, a potent inhibitor of nucleoside transport, prevents the excretion of inosine and depresses the rate of purine biosynthesis to that of wild type cells. These concentrations of dipyridamole have no effect on cellular growth rate or on the intracellular nucleoside triphosphate or phosphoribosylpyrophosphate pools. We suggest that dipyridamole might also be useful in ameliorating purine overproduction associated with hyperuricemia and gout.

Animals↗
PubMed1984

Effect of aspirin and dipyridamole on the patency of lower extremity bypass grafts.

Recent clinical studies indicate that the use of aspirin and dipyridamole improves graft patency rates in patients with infrainguinal polytetrafluoroethylene (PTFE) grafts and aortocoronary vein grafts. We undertook a prospective, double-blind, randomized study to determine whether these drugs administered postoperatively to patients with PTFE or autologous vein infrainguinal bypasses would improve graft patency during the first 24 months after operation. Patients received either aspirin 325 mg and dipyridamole 75 mg or identical placebo tablets three times a day, taken orally. Patency rates were compared by computing standard life tables and comparing cumulative patency rates. One hundred patients with 102 grafts were studied. The cumulative patency rate at 24 months was not significantly different for the treatment (57%) versus control (67%) groups or for any subgroup. We conclude that aspirin and dipyridamole administered postoperatively in the doses used in this study do not improve the overall patency rates of vein or PTFE infrainguinal bypass grafts.

Aged↗
PubMed1984

[The dipyridamole test in the diagnosis of ischemic heart disease in women].

Bicycle ergometry and the dipyridamol test were performed in 25 females with coronary artery stenosis and 42 with unchanged coronary arteries (according to the coronarography data). The sensitivity of the dipyridamol test was 80% at its specificity was 78% according to the electrocardiographic data that correlated well with those of bicycle ergometry. The dipyridamol test can be used for examining females with suspected coronary heart disease.

Adult↗
PubMed1981

Prevention of venous thrombosis by dipyridamole-naproxen and low-dose heparin in patients undergoing hysterectomy.

Orally administered dipyridamole in combination with naproxen was compared with subcutaneously administered low-dose heparin in prevention of deep venous thrombosis after abdominal hysterectomy. The radioactive fibrinogen test was used to diagnose thrombosis. Only one patient in the total series of 65 developed thrombosis. She belonged to the dipyridamole-naproxen group; the oral intake of the agents was disturbed by postoperative gastrointestinal side-effects. Vomiting and headache were more common in the dipyridamole-naproxen group, but wound complications (haematomas, ruptures and infections) were more common in the low-dose heparin group.

Administration, Oral↗
PubMed1982

[Dose-dependent increase in prostacyclin synthesis from various vascular tissues by dipyridamole].

Due to the more detailed knowledge of prostaglandin metabolism in the recent past increasing interest was focused onto dipyridamole acting as platelet active substance. It was the goal of this study to investigate whether dipyridamole is able to exert any effect on vascular PGI2-synthesis. It is demonstrated that dipyridamole has a dose-dependent (0.1-100 microM) increasing effect on PGI2-synthesis or 6-oxo-PGF1 alpha-levels, respectively (the stable metabolite of prostacyclin). At a dose range of more than 10 microM this increase reaches the level of significance. Assuming that PGI2 acts as a local hormone in the vascular system this effect on PGI2-synthesis stimulation might contribute to the knowledge of the in vivo action of the substance.

Animals↗
PubMedDate not supplied

Prevention of early reocclusion by dipyridamole and ASA in arterial reconstructive surgery.

In this prospective study 364 patients were subjected to different types of arterial reconstructive surgery. The patients were randomly divided into four groups according to the type of antithrombotic medication given. During the hospitalization period there were no reocclusions in the dipyridamole/ASA group of 93 patients compared with 12 reocclusions in the control group of 86 patients. The difference was statistically highly significant. The difference between the control group and the given dipyridamole or ASA was not statistically significant. Dipyridamole and ASA were tolerated well by the patients in this clinical trial. This was the first clinical investigation to prove the effectiveness of dipyridamole and ASA medication in the prevention of reocclusions in arterial reconstructive bypass surgery.

Arterial Occlusive Diseases↗
PubMed1981

[Stimulation of prostacyclin biosynthesis as a possible mechanism of action of dipyridamole (author's transl)].

In microsomes of pig aorta, isolated perfused hearts of guinea-pigs, rabbit vessel preparations and homogenates of rat lungs 2,6-bis-[bis-(beta-hydroxyethyl)-amino]-4,8-dipiper-idino-pyrimido-[5,4-d]pyrimidine (dipyridamole) application caused a marked stimulation of prostacyclin biosynthesis. The oxygen incorporation into arachidonic acid indicating cyclooxygenase and lipoxydase activity under the influence of lyophilised ram vesicle microsomes was increased by dipyridamole. The formation of malondialdehyde and thromboxane A2 in platelet rich plasma of rabbits remained uninfluenced. On the other side the formation of thromboxane A2 was moderately inhibited in homogenates of guinea-pig lungs. The arachidonic acid-induced thrombus formation and following death of rabbits remained uninfluenced. The results indicate that dipyridamole causes a relatively specific alteration of the prostaglandin metabolism stimulating the biosynthesis of prostacyclin but without effect or only moderate inhibition of the formation of thromboxane A2. These effects could be looked upon as an important mechanism for the cardiovascular action of the drug.

Animals↗
PubMedDate not supplied

Does a rhythmicity of serum concentrations and urinary excretion of dipyridamole exist during long-term treatment?

No daily rhythmicity of changes in dipyridamole (Curantyl-Germed) concentration in the blood serum of chronically treated patients receiving orally 75 mg of dipyridamole every 8 hr was found. The urinary excretion of dipyridamole was 1.37 mg/day (0.6% of the daily dose) and was significantly lower between 18.00--2.00 hr in comparison with excretion between 2.00--0.00 and 10.00-18.00.

Administration, Oral↗
PubMed1981

Effect of nicotinic acid and dipyridamole on tissue blood flow in peripheral vascular disease.

The effect of 2-weeks' treatment with daily doses of 150 mg nicotinic acid, 300 mg dipyridamole and placebo, in random order, on muscle blood flow and skin temperature gradient in the legs was measured in 6 patients with advanced arteriosclerotic peripheral vascular disease. Mean resting skin temperature gradient and muscle blood flow were uninfluenced by any of these treatments. Dipyridamole, but not nicotinic acid, caused a significant increase in exercise muscle blood flow compared to placebo (p less than 0.01). This improvement was maintained after 2-months' continuous treatment at the end of the trial. It is concluded that dipyridamole may be of value in the medical management of peripheral vascular disease.

Adult↗
PubMed1995

Long-term corticosteroid and dipyridamole treatment of membranoproliferative glomerulonephritis type I in children.

Eighteen patients with biopsy-proven membranoproliferative glomerulonephritis (MPGN) type I (16 diffuse, 2 focal) and a minimum of three years of follow-up (median 6.0 years, range 3 to 15.5 years) were treated with corticosteroids combined with dipyridamole. Initial therapy consisted of intravenous methylprednisolone pulses and/or daily oral prednisolone at the dose of 1 mg/kg combined with dipyridamole at the dose of 5 mg/kg, depending on the disease severity. Corticosteroid dosage was then reduced according to clinical improvement. At the start of therapy, 12 patients had microscopic hematuria or mild proteinuria, three patients had heavy proteinuria and three patients had insufficient renal function. At a median of 53 months of treatment, 89% of the children had normal or mildly abnormal urinary findings with normal renal function. Follow-up biopsy revealed improved active glomerular injury in all children. Although one case progressed to end-stage renal failure, the renal survival of our patients was 94% at 4 to 10 years after clinical onset. No patient suffered a relapse during corticosteroid dosage adjustment, nor did any unacceptable complications arise during the regimen. Eleven patients stopped the regimen because their renal function and urinalysis had normalized, and they remained in remission for a median of 32 months. These results suggest that long-term, tapering and limited use of corticosteroids combined with dipyridamole is useful and safe for children with MPGN type I.

Administration, Oral↗
PubMedDate not supplied

Selection of N-(phosphonacetyl)-L-aspartate resistant Chinese hamster mutants in the presence of the uridine uptake inhibitor dipyridamole.

In mammalian cells selected in culture for resistance to PALA the CAD gene is amplified and these cells are a widely used model system to study gene amplification. Selection of resistant mutants is routinely performed in medium supplemented with dialyzed serum, because the cytotoxic effect of PALA is reversed by uridine, which is contained in serum. We have shown that in Chinese hamster cells dipyridamole reduced uridine uptake to less than 5% with limited effect on cell survival. Moreover, in medium supplemented with complete serum and 10 microM dipyridamole the toxicity of PALA was similar to that obtained in medium containing dialyzed serum. We then used 10 microM dipyridamole to inhibit uridine uptake during selection of PALA resistant colonies and found that both the frequency and the type of mutants were as those obtained in the presence of dialyzed serum. In particular, in the five mutants tested, the mechanism of resistance to PALA was amplification of the CAD gene.

Animals↗
PubMedDate not supplied

Evaluation of coronary artery disease by dipyridamole echocardiography test.

Role of oral dipyridamole echocardiography test (DET) was evaluated in 50 patients with effort angina. All patients underwent coronary angiography, the day after oral DET. The echo studies were performed at rest and 65 +/- 15 minutes after 300 mg of oral dipyridamole. Segmental wall motion was analysed in a 16 segment model and a wall motion score index (WMSI) was generated for the entire left ventricle both at rest and following the drug. WMSI was significantly higher after oral dipyridamole, (p < 0.001) compared to resting condition with increased sensitivity (86% vs 74%). When results of DET were compared with coronary angiography, the correlation of WMSI was statistically significant in three vessel disease (p < 0.001), two vessel disease (p < 0.001) as well as for left anterior descending lesions (p < 0.001). However, it was insignificant for single vessel disease, viz, right coronary artery and circumflex artery. Thus we conclude that oral DET is a safe, inexpensive, sensitive and non-exercise dependent method for demonstrating myocardial ischaemia with high diagnostic accuracy.

Coronary Angiography↗
PubMed1994

Transient neurological events during dipyridamole stress test: an arterial steal phenomenon?

Dipyridamole-associated adverse neurological side effects have not been extensively described. We present two cases of dipyridamole-associated transient motor neurological events with no evidence of residual neurological deficits detected clinically or by head CT. The patients showed no evidence of significant extracranial (internal carotid) artery disease. We propose the presence of a regional cerebral perfusion disturbance due to an intracranial vascular steal phenomenon as the mechanism for the above side effects of dipyridamole.

Aged↗
PubMed1993

Noradrenaline reduces cardiovascular effects of the combined dipyridamole and AMP administration but preserves radioprotective effects of these drugs on hematopoiesis in mice.

Recent results of the authors have demonstrated that the elevation of extracellular adenosine induced by the combined administration of dipyridamole, a drug inhibiting the cellular uptake of adenosine, and adenosine monophosphate (AMP), a soluble adenosine prodrug, mediates radioprotective effects in mice. Furthermore, it has been shown that this action is induced by at least two mechanisms: (1) protection by hypoxia as a result of the effects of treatment on the cardiovascular system (bradycardia, vasodilation), and (2) an enhanced regeneration of the radiation-perturbed hematopoiesis. Here, it was ascertained that the joint use of an optimal dose of noradrenaline given with dipyridamole and AMP combination eliminates the hypothermic and hypoxic effects of the treatment, but preserves the radioprotective action of dipyridamole and AMP combination in terms of hematopoietic recovery and partially also survival enhancing effects of the drugs in gamma-irradiated mice. These findings might be of importance for attempts to obtain available and tolerable radioprotective pharmacological prescriptions for clinical use.

Adenosine Monophosphate↗
PubMed1993

[Scintigraphy of myocardial perfusion combined with pharmacologic stress with dipyridamole].

PURPOSE: To analyze adverse reactions (AR), hemodynamic and electrocardiographic changes and thallium scintigraphy (TS) results, during pharmacological stress with dipyridamole (SD), correlating these data to the presence and extension of coronary artery disease (CAD). METHODS: We studied 126 patients, 66 had no evidence of cardiovascular disease (G1) and 60 had critical occlusive CAD > or = 70% stenosis (G2). Most of them were male, mean age 56.5 +/- 10.9 years old. All patients were submitted to TS after receiving 0.56 mg/kg of dipyridamole intravenously (0.14 mg/min during 4 min) followed by 111MBq of thallium-chloride-201. Conventional ECG was recorded before and after SD; heart rate (HR) and arterial pressure (AP) were monitored during dipyridamole infusion. All signals and/or symptoms were observed. RESULTS: Cine-coronarography showed 22 patients (37%) with one vessel disease (VD) (G2a), 26 (46%) with two VD (G2b) and 12 (20%) with three VD (G2c). Of the 126 patients 63% did not present symptoms. Flushing (25%) and sick-headache (12%) were most frequent AR. Typical angina was reported by one G1 patient (1.5%) and six G2 patients (10%) (p < 0.05). HR increased 18.09 +/- 12.27% and 12.40 +/- 4.90%, systolic blood pressure varied -5.2 +/- 7.5% and -4.3 +/- 6.5% in G1 and G2, respectively. These parameters are not correlated to CAD presence and extension. ST depression and ectopic beats occurred in 5% and 11% of G1 patients, in 15% and 30% of G2 patients, respectively (p < 0.05). Typical angina was more common in G2a and G2b; ST changes in G2b and G2c; and arrhythmia in G2c (not significant). Sensitivity of TS associated to SD was 84%, comparable to stress exercise thallium test. CONCLUSION: TS associated to SD, a noninvasive, safe with low morbidity and few collateral effects method is an option to patients with limitations to physical exercise tests.

Adult↗