Circulation, Vol 90, 2710-2715, Copyright © 1994 by American Heart Association
A Maresta, M Balducelli, L Cantini, A Casari, R Chioin, M Fabbri, A Fontanelli, PA Monici Preti, S Repetto and S De Servi
BACKGROUND: Trapidil is an antiplatelet drug with specific platelet-
derived growth factor antagonism and antiproliferative effects in the rat
and rabbit models after balloon angioplasty. METHODS AND RESULTS: The
Studio Trapidil versus Aspirin nella Restenosi Coronarica (STARC) is a
multicentric, randomized, double-blind trial to assess the effects of
trapidil in angiographic restenosis prevention after percutaneous
transluminal coronary angioplasty (PTCA). Patients received either trapidil
100 mg TID or aspirin at the same dosage at least 3 days before angioplasty
and for 6 months thereafter. Coronary angiograms before PTCA, after PTCA,
and at 6-month follow-up were quantitatively analyzed with manual calipers.
Of the initial 384 patients recruited, 254 were evaluable for restenosis
analysis (128 trapidil, 126 aspirin). Restenosis, defined as a loss of
initial percent gain after PTCA of at least 50% (primary end point),
occurred in 24.2% of the trapidil group and 39.7% of the aspirin group (P
< .01). A similar result was obtained when restenosis per vessel was
considered (trapidil, 23.3%; aspirin, 36.9%; P = .018). Clinical events at
follow-up were similar in the two groups except that recurrent angina was
significantly more frequent in the aspirin group, 43.7% versus 25.8% in the
trapidil group (P < .01). Trapidil was well tolerated: only 6 patients
had to discontinue the drug because of side effects, which was not
different from the aspirin group. CONCLUSIONS: Trapidil reduces restenosis
after PTCA at the dosage of 100 mg TID and favorably influences the
clinical outcome thereafter.
ARTICLES
Trapidil (triazolopyrimidine), a platelet-derived growth factor antagonist, reduces restenosis after percutaneous transluminal coronary angioplasty. Results of the randomized, double-blind STARC study. Studio Trapidil versus Aspirin nella Restenosi Coronarica
Department of Clinical and Interventional Cardiology, Ospedale per gli Infermi, Faenza (RA), Italy.
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