In a double-blind study, 48 patients (age range, 47 to 75) with angina pectoris received either dipyridamole (Persantine) (200 mg daily) or placebo for an average of five months. Nitroglycerin was taken sublingually as required for relief of acute attacks. Previous use of long-acting nitrates had produced no significant improvement.Of the 26 patients receiving dipyridamole, 21 (81 per cent) showed an overall satisfactory clinical response (marked or moderate improvement) compared to 2 (9 per cent) of the 22 receiving placebo. The difference between the two treatments was statistically significant. Evaluation of objective criteria also showed the superiority of dipyridamole. The mean improvement for drug group vs, placebo group was as follows: decrease in anginal attacks, 48/24 per cent; decrease in need for nitroglycerin, 50/18 per cent; and increase in walking distance, 84/36 per cent. In terms of subjective evaluation of anginal pain, 69 per cent of the drug group improved compared to 18 per cent of the placebo group.Two patients had reactions while taking the drug. Transient blurred vision was noted by one patient, but it did not interfere with continuation of dipyridamole. Nausea and insomnia in another patient (not in the final study group) caused cessation of therapy. No reactions were reported among the placebo patients.From the results of this controlled study it is concluded that dipyridamole, a non-nitrate coronary vasodilator, is a relatively safe and effective agent for the long-term treatment of patients with angina pectoris.
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