Circulation, Vol 82, 17-26, Copyright © 1990 by American Heart Association
F Balsano, P Rizzon, F Violi, D Scrutinio, C Cimminiello, F Aguglia, C Pasotti and G Rudelli
We conducted a controlled multicenter trial with central randomization and
evaluation of events under blind conditions involving 652 patients with
unstable angina. Patients were treated either with conventional therapy
alone (group C) (n = 338) or with conventional therapy combined with an
inhibitor of platelet aggregation, ticlopidine 250 mg b.i.d. (group C + T)
(n = 314). Patients were assigned randomly within 48 hours of admission and
followed up for 6 months. With the "intention-to- treat" approach, the
primary end points, vascular death and nonfatal myocardial infarction, were
observed in 13.6% of the patients in group C and in 7.3% of the patients in
group C + T, which is a reduction in risk of 46.3% (p = 0.009). Vascular
mortality was 4.7% in patients in group C and 2.5% in patients in group C +
T, which is a reduction in risk of 46.8% (p = 0.139). The risk of nonfatal
myocardial infarction was reduced by 46.1% (p = 0.039), with a frequency of
8.9% in patients in group C and 4.8% in patients in group C + T. New Q wave
myocardial infarction occurred with a frequency of 6.8% in patients in
group C and 3.8% in patients in group C + T, which is a reduction in risk
of 44.1% (p = 0.091). Fatal and nonfatal myocardial infarction was 10.9% in
patients in group C and 5.1% in patients in group C + T, which is a
reduction in risk of 53.2% (p = 0.006). These findings confirm the
importance of platelets in the pathogenesis of unstable angina and the
usefulness of antiplatelet treatment for the prevention of cardiovascular
events.
ARTICLES
Antiplatelet treatment with ticlopidine in unstable angina. A controlled multicenter clinical trial. The Studio della Ticlopidina nell'Angina Instabile Group
University La Sapienza, Rome, Italy.
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