Cilostazol, a Novel Cyclic AMP Phosphodiesterase Inhibitor, Prevents Reocclusion After Coronary Arterial Thrombolysis With Recombinant Tissue‐Type Plasminogen Activator
作者:
Shuichi Saitoh,
Tomiyoshi Saito,
Atsushi Otake,
Takayuki Owada,
Minoru Mitsugi,
Hiromichi Hashimoto,
Yukio Maruyama,
期刊:
Arteriosclerosis and Thrombosis: A Journal of Vascular Biology
(OVID Available online 1993)
卷期:
Volume 13,
issue 4
页码: 563-570
ISSN:1049-8834
年代: 1993
出版商: OVID
关键词: acute myocardial infarction;recombinant tissue-type plasminogen activator;cilostazol;cyclic AMP phosphodiesterase inhibitor
数据来源: OVID
摘要:
Inhibitors of cyclic nucleotide phosphodiesterase hydrolysis of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate are known to inhibit platelet aggregation, which plays an important role in acute reocclusion after thrombolysis in acute myocardial infarction. In the present study of a canine preparation of coronary artery thrombosis superimposed on high-grade stenosis, we tested whether the antithrombotic agent cilostazol, an inhibitor of cAMP phosphodiesterase, could prevent acute reocclusion or sustain coronary blood flow after thrombolysis when used with recombinant tissue-type plasminogen activator (rt-PAJ and heparin. Intravenous infusion of rt-PA (0.5 mg/kg body wt for 30 minutes) and heparin (a 150 11)/kg body wt i.v. bolus and then 25 IU/kg body wt per hour i.v.) was combined with cilostazol (0.6 or 1.8 mg/kg body wt for 60 minutes). Without cilostazol, reperfusion was observed in seven of eight dogs, but reocclusion occurred in six of these seven dogs after 9±2 minutes. After administration of 1.8 mg/kg body wt cilostazol (group B-2; a 120-minute observation after the start of rt-PA infusion), reperfusion occurred in all seven dogs (p<0.05 versus control group), and brief cyclic reocclusion was observed in only one dog 63 minutes after reperfusion. At the same dose of cilostazol (group B-2L; a 240-minute observation after the start of rt-PA infusion), reperfusion occurred in all five dogs (p<0.05 versus control group), and coronary blood flow was well maintained except for one short reocclusion in one dog. Cilostazol inhibited cyclic flow reduction in a dose-dependent fashion. We conclude that cilostazol is a new potent antiplatelet agent for preventing reocclusion after coronary thrombolysis, when used in combination with rt-PA and heparin.
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