74369
document
Lack of effect of warfarin on the restenosis rate or on clinical outcome after balloon coronary angioplasty . Between September 1985 and April 1987 , 110 consecutive patients who had successful coronary angioplasty were included in a randomised prospective controlled evaluation of the effects of warfarin on restenosis . The warfarin ( n = 56 ) and the control ( n = 54 ) groups were not different in terms of age , sex , previous coronary bypass surgery or coronary balloon angioplasty , severity of symptoms , and frequency of multivessel disease or of total coronary occlusions . Warfarin was started on the day of the procedure and the dosage was adjusted to maintain the thromboplastin international normalised ratio greater than or equal to 2.5 . One hundred and five ( 96 % ) of the patients were given verapamil and other antianginal drugs were prescribed as needed . Low molecular weight dextran and heparin were given during the procedure and heparin was continued for 24 hours in all patients . One hundred and eight ( 98 % ) of patients were followed up clinically after a median of five months ( range 1-20 ) . Eighty five ( 77 % ) had follow up angiography at five months . In the warfarin group symptoms improved in 46 ( 85 % ) patients by at least 1 angina class and 31 ( 57 % ) were symptom free ; the exercise test remained positive in 20 ( 36 % ) patients and the angiographic restenosis rate was 25 % per lesion and 29 % per patient . There were no major bleeding complications . In the control group 46 ( 85 % ) patients were improved by at least 1 angina class and 31 ( 57 % ) were symptom free ; the exercise test was positive in 11 ( 21 % ) patients and the angiographic restenosis rate was 33 % per lesion and 37 % per patient . Although the incidence of angiographic restenosis tended to be lower with warfarin , none of these differences was significant . These data suggest that the combination of verapamil and warfarin , in the absence of aspirin , is not significantly better than verapamil alone in preventing symptom recurrence or angiographic restenosis after coronary angioplasty .
74370
Intervention_Pharmacological
warfarin
74371
Intervention_Pharmacological
warfarin
74372
Intervention_Pharmacological
warfarin
74373
Intervention_Control
control
74374
Intervention_Pharmacological
Warfarin
74375
Intervention_Pharmacological
verapamil
74376
Intervention_Pharmacological
other antianginal drugs
74377
Intervention_Pharmacological
Low molecular weight dextran and heparin
74378
Intervention_Pharmacological
heparin
74379
Intervention_Pharmacological
warfarin
74380
Intervention_Pharmacological
warfarin
74381
Intervention_Pharmacological
verapamil
74382
Intervention_Pharmacological
warfarin
74383
Intervention_Pharmacological
aspirin
74384
Outcome_Physical
restenosis rate
74385
Outcome_Physical
symptoms
74386
Outcome_Other
symptom free
74387
Outcome_Physical
angiographic restenosis rate
74388
Outcome_Adverse-effects
major bleeding complications
74389
Outcome_Other
exercise test
74390
Outcome_Physical
angiographic restenosis rate
74391
Outcome_Physical
angiographic restenosis
74392
Participant_Condition
Between September 1985 and April 1987 , 110 consecutive patients who had successful coronary angioplasty