Prevention of aortocoronary vein-graft attrition with low-dose aspirin and triflusal, both associated with dipyridamole: a randomized, double-blind, placebo-controlled trial

Abstract

A randomized, double-blind, placebo-controlled trial was performed in 209 patients to evaluate the efficacy of a low dose of aspirin plus dipyridamole or that of a new antiplatelet agent (triflusal) plus dipyridamole in the prevention of aortocoronary vein-graft occlusion. An angiographic control performed in 161 patients 9 days after surgery showed no significant differences between groups, but a new control on 138 of those patients 6 months later did show significant linear trends towards fewer distal anastomosis occlusions (P = 0.027) from the placebo (24%, 22/91) to the aspirin (16%, 17/106) and to the trifusal groups (12%, 10/86), and towards fewer new occlusions (P = 0.056) from 12% (9/78) to 10% (10/99) and to 2.6% (2/78), respectively, in the same groups. A multivariate logistic regression model, used to determine the effect of 33 variables on distal anastomosis occlusion at 6 months control, demonstrated that diameter of distal bed (P = 0.006), moderately to severely atherosclerotic distal bed (P = 0.003) and the interactions between poor distal bed and triflusal (P = 0.005) were independent predictors of occlusion. Thus, triflusal plus dipyridamole appeared superior to low-dose aspirin plus dipyridamole in the prevention of vein-graft occlusion, independently of coronary and vein-graft determinants of occlusion.

Antithrombotic Therapy in Patients With Saphenous Vein and Internal Mammary Artery Bypass Grafts

“…13,14,39 Triflusal is a platelet inhibitor structurally related to aspirin. 40 Because of the limited evidence about efficacy of sulfinpyrazone and triflusal, we do not make a recommendation regarding these antiplatelet agents. 40 When started 1 day preoperatively, therapy with triflusal, 900 mg/d, plus dipyridamole, 225 mg/d, resulted in fewer distal anastomotic occlusions compared to aspirin, 150 mg/d, plus dipyridamole, 225 mg/d.…”

Polymeric drugs with prolonged sustained delivery of specific anti-aggregant agents for platelets: kinetic analysis of the release mechanism

“…Poly(THEMA-co-HEMA-co-DMA) terpolymer (THHD17) was prepared in the same conditions as the copolymer but using the following feed molar compositions: F THEMA = 0.17, F HEMA = 0.22 and F DMA = 0.61. 1 …”

“…Different polymeric systems derived from Triflusal (a well-known anti-aggregant agent for platelets [1,2], marketed as Disgren ® ) have been recently developed in our laboratory. These systems are based on a methacrylic derivative of Triflusal (THEMA), the synthesis of which has been described in a previous article [3].…”

Hydrophilic Polymer Drug from a Derivative of Salicylic Acid: Synthesis, Controlled Release Studies and Biological Behavior

“…closely related to aspirin and a characteristic pharmacological profile. [7,8] In addition to the structure of salicylic acid, this drug has acetyl groups which are considered to be related with the irreversible deactivation of platelets in the aggregation process (and therefore in the inhibition of cellular thrombus), by an irreversible inhibition of platelet cyclooxigenase activity. Besides that, Triflusal and its main metabolite HTB (2-hydroxy-4-trifluoromethylbenzoic acid) are phosphodiesterase cAMP inhibitors, so HTB also displays antiaggregant activity.…”