INFLUENCE OF TAPROSTENE, A STABLE PROSTAC YCLIN ANALOG, ON ISCHEMIC ST-DEPRESSION IN EXERCISE ECG OF PATIENTS WITH CORONARY-ARTERY DISEASE

Prostaglandins and prostacyclin are potent vasodilators with marked he modynamic effects, i.e., both improve cardiac function and possibly ca use myocardial ischemia. In order to assess the stable prostacyclin an alogon taprostene (T) we first performed an open preliminary study wit h increasing T-doses (6.5-50 ng/kg/min) and, secondly a double-blind c rossover study versus placebo to investigate its influence on ischemic ST-segment depression during exercise stress testing under continuous T-infusions of 25 ng/kg/min (in one case 12.5 ng/kg/min). Eleven of 1 2 normotensive male patients (age 40 to 60, mean 52.8 +/- 8.4 years) s uffering from angiographically proven coronary heart disease and stabl e angina pectoris completed the study. T was well tolerated, even unde r increasing doses, and blood pressure and the ECG parameters did not change. The double-blind study revealed no variation in the extent of ischemic ST-segment depression when compared to placebo, and all other ECG parameters as well as the blood pressure remained unaffected. Thu s, myocardial ischemia cannot be ruled out completely under T, but ear lier clinical findings may be confirmed characterizing T as a marked c ytoprotective agent and, to a less degree, as a potent vasodilator.