EFFECTS BERAPROST SODIUM, A NEW PROSTAGLANDIN I-2 ANALOG, ON PARAMETERS OF HEMOSTASIS, FIBRINOLYSIS, AND MYOCARDIAL-ISCHEMIA IN PATIENTS WITH EXERTIONAL ANGINA

The purpose of this study was to investigate the effects of beraprost sodium, a stable prostacyclin analog, on the parameters of hemostasis, fibrinolysis, and myocardial ischemia in patients with exertional ang ina. Thirty-one patients with exertional angina who had significant or ganic coronary artery stenosis in at least one of the three major coro nary arteries were selected. All patients underwent quantitative exerc ise thallium-201 emission computed tomography before and 1 month after 120 mu g per day of beraprost sodium administration. Before exercise, blood samples were collected from 8:30 a.m. to 9:30 a.m. after the pa tients had been lying in bed undisturbed for at least 10 minutes. Plas ma platelet factor 4 (PF4), fibrinopeptide A (FPA), tissue plasminogen activator antigen (t-PA), and plasminogen activator inhibitor-1 activ ity (PAI-1) were measured. There were no significant differences in ex ercise parameters on both exercise tests. However, both the extent and severity scores of ischemia were significantly aggravated (p < 0.05 f or both) during beraprost sodium administration. Plasma FPA levels dec reased significantly during beraprost sodium administration (p < 0.01) . Likewise, plasma PF4 levels decreased significantly during beraprost sodium administration (p < 0.05). As for plasma t-PA antigen levels, there was no significant difference before versus during beraprost sod ium administration. Plasma PAI-1 activity levels decreased significant ly during beraprost sodium administration (p < 0.05). The results indi cate that beraprost sodium has strong antithrombogenic properties. How ever, its aggravation of myocardial ischemia may limit clinical usage.