This result was not influenced by the dose of dipyridamole or type of presenting vascular disease .
For patients who presented with arterial vascular disease , there was no evidence that dipyridamole , in the presence or absence of another antiplatelet drug reduced the risk of vascular death , though it reduces the risk of further vascular events .
This benefit was found only in patients presenting after cerebral ischaemia .
There was no evidence that dipyridamole alone was more efficacious than aspirin
BACKGROUND Patients with limited cerebral ischaemia of arterial origin are at risk of serious vascular events ( 4 % to 11 % annually ) .
Aspirin reduces that risk by 13 % .
In one trial , adding dipyridamole to aspirin was associated with a 22 % risk reduction compared with aspirin alone .
OBJECTIVES To assess the efficacy and safety of dipyridamole versus control in the secondary prevention of vascular events in patients with vascular disease .
Dipyridamole in chronic stable angina pectoris; a randomized, double blind, placebo-controlled, parallel group study.
BACKGROUND Oral dipyridamole induces accumulation of endogenous adenosine , which in a hypoxic milieu exerts experimentally an angiogenic effect on coronary collateral circulation . A meta- analysis of 13 r and omized placebo-controlled trials published between 1960 and 1992 showed evidence of benefit for dipyridamole in the treatment of angina pectoris , especially with longer duration of treatment . Aim To assess the efficacy and safety of dipyridamole in the treatment of patients with chronic stable angina in a large scale , international , r and omized , placebo-controlled , parallel group study . METHODS Four hundred patients with chronic stable angina pectoris and a positive treadmill exercise test were r and omized to receive either modified release dipyridamole ( 200 mg b.i.d . p.o . , n=198 ) or corresponding placebo ( n=202 ) , for 24 weeks as an add-on to conventional antianginal therapy and for 4 additional weeks as monotherapy -- the latter after withdrawal of st and ard treatment with calcium antagonists and /or beta-blockers and /or long-acting ( prophylactic ) nitrates . RESULTS Of the 198 patients r and omized to  dipyridamole  , 134 completed the add-on and only 12 the monotherapy phase . Of the 202 patients r and omized to placebo , 162 reached the add-on and only 12 the monotherapy phase . Serious adverse events occurred in 15 patients with dipyridamole and in 12 with placebo ( 7.6 % vs 6.0 , P=0.52 ) . Increase over the baseline treadmill exercise test was similar in the treatment groups at each stage of the trial for all the main efficacy parameters : total treadmill exercise test duration ; time to first anginal pain ( except for a -13 s difference in favour of placebo at week 24;P=0.040 ) ; time to ST segment depression > 0.1 mVolt ( except for a + 21 s difference in favour of dipyridamole at week 8;P=0.024 ; this latter difference was totally attributable to patients with lower exercise tolerance -- Bruce stage II at study entry ) . CONCLUSION In patients with chronic stable angina treated with regular antianginal background medication , the use of oral dipyridamole is safe and well tolerated . Antianginal and antiischaemic efficacy , as assessed by exercise testing , is comparable to placebo , except for a beneficial effect on time to ischaemia after 2 months , totally attributable to patients with lower exercise tolerance at study entry
This result was not influenced by the dose of dipyridamole or type of presenting vascular disease .
For patients who presented with arterial vascular disease , there was no evidence that dipyridamole , in the presence or absence of another antiplatelet drug reduced the risk of vascular death , though it reduces the risk of further vascular events .
This benefit was found only in patients presenting after cerebral ischaemia .
There was no evidence that dipyridamole alone was more efficacious than aspirin
BACKGROUND Patients with limited cerebral ischaemia of arterial origin are at risk of serious vascular events ( 4 % to 11 % annually ) .
Aspirin reduces that risk by 13 % .
In one trial , adding dipyridamole to aspirin was associated with a 22 % risk reduction compared with aspirin alone .
OBJECTIVES To assess the efficacy and safety of dipyridamole versus control in the secondary prevention of vascular events in patients with vascular disease .