PLATELET DRUG TRIAL IN CORONARY DISEASE PROGRESSION

血小板似乎在糖尿病的发生和发展中起着重要作用。 冠状动脉粥样硬化(CAD)与血栓形成和微栓子 并发症。血小板存活期缩短的患者中有50%-75% CAD。这种增加的血小板消耗部分或完全得到纠正 使用了血小板抑制药。因此，在冠心病中进行了一项血小板抑制药物试验 进步是强制性的。病情进展风险高的患者或 血栓栓塞症和微栓塞症并发症可通过测量加以识别 对血小板存活时间的影响；这也必须进行测试。血浆中的血小板 因子4水平可能与血小板存活率呈负相关，并可能是 识别冠心病高危患者的更快、更经济的方法 进展和并发症。 潘生丁和潘生丁联合应用的前瞻性双盲血小板抑制药物试验 阿司匹林与安慰剂(乳糖)将使用选择性但随机的方法进行试验 临床接受治疗的患者分配到治疗组和对照组 因冠心病而进行的左心室和冠状动脉造影，谁是 随后接受了医疗治疗。重复左心室和冠状动脉造影术 将在五年后上演。这项研究的目标是确定 潘生丁-阿司匹林延缓冠心病进展的疗效。这个 治疗组和对照组在随访后进行终点比较 是冠心病进展和冠状动脉病变的冠状动脉造影证据 开发新的计算机辅助设计。~(51)铬标记自体血小板存活 所有患者的血小板和血浆血小板因子4水平将被检测。 治疗前和治疗后五年。 我们每天都会从我们的心脏插管手术中识别冠心病患者 哪些实验室有资格参加冠脉中的血小板抑制药物试验 外科手术‘(HL 21533)。那些未经手术治疗的冠心病患者将 作为这项研究的候选者，这两个药物试验可能会在 平行的。

Platelets seem to play a significant role in the development and progression of coronary atherosclerosis (CAD) and in the thrombotic and microembolic complications. Shortened platelet survival occurs in 50-75% of patients with CAD. This increased platelet consumption is partially or completely corrected with platelet inhibitor drugs. Thus, a platelet inhibitor drug trial in CAD progression is mandatory. Patients who have a high risk of progression or thromboembolic and microembolic complications may be identifiable by measurement of platelet survival time; this also has to be tested. The plasma platelet factor 4 level may correlate inversely with platelet survival and would be a faster and more economical means of identifying patients at high risk of CAD progression and complications. A prospective, double-blind platelet inhibitor drug trial with dipyridamole and aspirin versus placebo (lactose) will be conducted using selective but random allocation to treatment and control groups of patients undergoing clinically indicated left ventricular and coronary angiography because of CAD and who are subsequently treated medically. Repeat left ventricular and coronary angiograms will be performed after five years. The goal of this study is to determine the effectiveness of dipyridamole-aspirin in reducing the progression of CAD. The end points to be compared in the treatment and control groups after a follow-up of five years are coronary arteriographic evidence of progression of CAD and development of new CAD. Platelet survival with 51 chromium labeled autologous platelets and plasma platelet factor 4 levels will be determined in all patients before and after five years of treatment. We are daily identifying CAD patients from our Cardiac catheterization laboratory who are eligible for the 'Platelet Inhibitor Drug Trial in Coronary Surgery' (HL 21533). Those CAD patients who are treated without surgery would be candidates for this study, and those two drug trials could be run in parallel.