A randomized comparison of trapidil (triazolopyrimidine), a platelet-derived growth factor antagonist, versus aspirin in prevention of angiographic restenosis after coronary artery Palmaz-Schatz stent implantation

The aim of the study is to assess the safety of trapidil in the setting of coronary stenting and to evaluate its efficacy in reducing angiographic in- stent restenosis. One hundred eighteen patients undergoing Palmaz-Schatz st ent implantation were randomly assigned to receive antiplatelet therapy usi ng either aspirin (325 mg/d) or trapidil (400 mg/d), in combination with ti clopidine (500 mg) for the first month. At entry, both groups were comparab le with regard to clinical, angiographic, and procedural characteristics. A t 6-month angiographic follow-up, >50% restenosis occurred in 15 of 52 lesi ons (28.8%) of the aspirin group and in 14 of 47 lesions (29.8%) of the tra pidil group (P = not significant, NS). At B-month clinical follow-up, there was no difference in the two groups in the rate of adverse events (2.0% vs . 2.1%, P = NS), medication side effects (4.0% vs. 4.2%, P = NS), and perip heral vascular complications (4.0% vs. 4.2%, P = NS). In conclusion, treatm ent with trapidil seems to be associated with a similar incidence of stent restenosis and adverse cardiac events as compared to aspirin and could be a valuable alternative to aspirin in the setting of coronary stenting. (C) 1 999 Wiley-Liss, Inc.