Antiplatelet treatment with ticlopidine in unstable angina: A controlled multicenter clinical trial

Francesco Balsano, Paolo Rizzon, Francesco Violi, Domenico Scrutinio, Claudio Cimminiello, Franco Aguglia, Carlo Pasotti, Giusi Rudelli

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)17-26
Number of pages10
JournalCirculation
Volume82
Issue number1
Publication statusPublished - 1990

Keywords

  • Antiplatelet
  • Clinical trials
  • Coronary heart disease
  • Ticlopidine
  • Unstable angina

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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