isbogrel and Coronary-Disease

A selective inhibitor of thromboxane A2 synthetase, CV-4151, has the unique property of increasing prostacyclin synthesis in addition to its anti-platelet aggregating effect. Prostacyclin inhibits the growth of smooth muscle cells which is considered to be an underlying mechanism of restenosis occurring after successful coronary angioplasty. A prospective randomized trial was conducted to determine whether CV-4151 could prevent restenosis. Administration was begun greater than or equal to 2 days before angioplasty, and continued until the follow-up study performed between 3 and 6 months after angioplasty. Follow-up angiography was performed in 58 patients (81 segments) taking the active drug and in 27 patients (35 segments) taking the placebo. The incidence of angiographic restenosis was 38.3% in the former group and 31.4% in the latter group. Thus, CV-4151 did not significantly reduce the incidence of restenosis, perhaps due to endothelial denudation after angioplasty preventing an increase of the subendothelial local prostacyclin level.

Topics: Angioplasty, Balloon, Coronary; Coronary Angiography; Coronary Disease; Fatty Acids, Monounsaturated; Female; Humans; Male; Middle Aged; Pyridines; Thromboxane-A Synthase

The purpose of this study was to determine whether thromboxane A2 (TXA2) is involved in the development of ventricular arrhythmias produced by coronary artery occlusion. Ventricular arrhythmias were induced by coronary artery occlusion in 66 male Sprague-Dawley rats. Rats were separated into 4 groups, and saline (n = 19) or CV4151 (a TXA2 synthetase inhibitor)(10 mg/kg, n = 14; 30 mg/kg, n = 15; or 100 mg/kg, n = 18) was injected intravenously 5 min before coronary artery occlusion. The antiarrhythmic effect of CV4151 was assessed in terms of the number of ventricular premature complexes (VPCs), the combined duration of ventricular tachycardia (VT) and ventricular fibrillation (Vf), the incidence of Vf, and the mortality rate within 30 min after occlusion. The total number of VPCs was as follows; control: 1789 +/- 330 beats: 10 mg/kg group: 1289 +/- 302 beats: 30 mg/kg group: 1008 +/- 229 beats: 100 mg/kg group: 986 +/- 275 beats, with no significant differences between groups. The incidence of Vf was significantly reduced in the 30 mg/kg and 100 mg/kg groups, as was the combined duration of VT and Vf and the mortality rate. Our results indicate that the TXA2 synthetase inhibitor CV4151 reduces the incidence of lethal arrhythmias induced by coronary artery occlusion in rats.

Topics: Animals; Arrhythmias, Cardiac; Coronary Disease; Enzyme Inhibitors; Fatty Acids, Monounsaturated; Male; Pyridines; Rats; Rats, Sprague-Dawley; Thromboxane-A Synthase

Topics: Angioplasty, Balloon; Animals; Coronary Disease; Dogs; Fatty Acids, Monounsaturated; Fiber Optic Technology; Pyridines; Thromboxane-A Synthase

Ten weeks old male Sprague-Dawley rats were used. One mg/kg of a calfskin type III collagen was injected into a tail vein under pentobarbital anesthesia, and the electrocardiogram (ECG) was recorded via leads I, II and III for 10 min. Abnormal ECG patterns, i.e., ST-T changes and incidence of arrhythmia, were shown after collagen injection, and some rats suffered cardiac arrest. Oral administration of (E)-7-phenyl-7-(3-pyridyl)-6-heptenoic acid (CV-4151), a thromboxane synthetase inhibitor, at the dose of 10 mg/kg two hr before the collagen injection made the ST-T changes small, and it reduced the incidence of cardiac arrest. The effect of CV-4151 was greater than that of 30 mg/kg of ticlopidine with the same type of treatment. Neither CV-4151 nor ticlopidine had any affect on collagen-induced decreases in the blood platelet count. However, plasma thromboxane (TX) B2 level in the CV-4151-treated group was very low in comparison with those in both the control and ticlopidine-treated groups at 10 min after the collagen injection. These findings indicate that TXA2 may contribute, at least partly, to the collagen-induced ECG changes and indicate that CV-4151 might be a favorable agent for the prevention of TXA2-mediated cardiac ischemia.

Topics: 6-Ketoprostaglandin F1 alpha; Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Collagen; Coronary Disease; Electrocardiography; Fatty Acids, Monounsaturated; Fatty Acids, Unsaturated; Humans; Pyridines; Rats; Rats, Inbred Strains; Thiophenes; Thromboxane B2; Ticlopidine

Topics: Animals; Coronary Disease; Dogs; Epoprostenol; Fatty Acids, Monounsaturated; Fatty Acids, Unsaturated; Pyridines; Rats; Thrombosis; Thromboxane B2; Thromboxane-A Synthase