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June 24, 1971New England Journal of Medicine352 citations

Pharmacologic Control of Thromboembolic Complications of Cardiac-Valve Replacement

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JSJay M. SullivanDHDwight E. HarkenRGRichard Gorlin

Key Result

Dipyridamole added to warfarin significantly reduced the frequency of arterial emboli compared to placebo (1.3% vs 14.3%) within 1 year in patients surviving prosthetic cardiac-valve replacement.

Study Design

Type

RCT (n=163)

Structured PICO

Does dipyridamole added to warfarin reduce arterial emboli in patients surviving prosthetic cardiac-valve replacement?

P
Population
163 patients surviving prosthetic cardiac-valve replacement, all receiving background anticoagulation with warfarin sodium
I
Intervention
Dipyridamole 400 mg daily added to warfarin sodium
C
Comparator
Placebo added to warfarin sodium
O
Outcome
Frequency of arterial embolization within one yearhard clinical

The addition of dipyridamole to warfarin significantly reduces the risk of arterial embolization in patients with prosthetic cardiac valves.

Main Result

Absolute Event Rate: 1.3% vs 14.3%

Abstract

Continued experience with the use of dipyridamole as an antithrombotic agent confirmed earlier impressions of the clinical effectiveness of this agent. Dipyridamole (400 mg daily) or a placebo was given to 163 patients surviving prosthetic cardiac-valve replacement. All patients received anticoagulation with warfarin sodium. Eighty-four patients entered the placebo group. Within one year, 11.9 per cent died, 14.3 per cent suffered arterial emboli, and 9.5 per cent discontinued their medication because of possible side effects. The dipyridamole group contained 79 patients, of whom 13.9 per cent died; arterial emboli developed in 1.3 per cent and 15.2 per cent discontinued their medication. The frequency of embolization in the dipyridamole group was significantly lower than that in the placebo group. There was no significant difference between the death rates or between the drug discontinuation rates of the two groups.

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Cite This Study

Sullivan et al. (1971) conducted an RCT in Prosthetic cardiac-valve replacement (n=163). Dipyridamole vs. Placebo was evaluated on Arterial emboli. Dipyridamole added to warfarin significantly reduced the frequency of arterial emboli compared to placebo (1.3% vs 14.3%) within 1 year in patients surviving prosthetic cardiac-valve replacement.

synapsesocial.com/papers/6a08cba68bd2868868ba0667https://doi.org/10.1056/nejm197106242842501
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