Chronic stable angina treatment dipyridamole

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor(s)-In-Chief: ; John Fani Srour, M.D.; Jinhui Wu, M.D.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview
Dipyridamole is a pyrimidopyrimidine derivative with poor anti-thrombotic efficacy and therefore not recommended for anti-platelet therapy in patients with chronic stable angina. Dipyridamole may also exacerbate anginal symptoms due to coronary steal phenomenon.

Mechanisms of benefit

 * Dipyridamole is a pyrimido-pyrimidine derivative.
 * Dipyridamole exerts vasodilator effects on coronary resistance vessels.

Contra-indications
Dipyridamole enhances exercise-induced myocardial ischemia even the usual oral dosage and hence it not used as an anti-platelet agent in patients with stable angina.

Adverse effects

 * Exercise induced myocardial ischemia
 * Exacerbation of anginal symptoms
 * Hypotension
 * Headache
 * Bronchospasm

Supportive trial data
In a post hoc analysis that investigated cardiac events in patients with coronary heart disease or MI at study entry, dipyridamole therapy did not result in a higher number of cardiac events such as angina pectoris, MI or death from all causes.

==ACC/AHA Guidelines- Pharmacotherapy to Prevent MI and Death and Reduce Symptoms (DO NOT EDIT)  == {{cquote|

Class III
1. Dipyridamole. (Level of Evidence: B)}}

Vote on and Suggest Revisions to the Current Guidelines

 * The Chronic Stable Angina Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

Guidelines Resources

 * The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina
 * The ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina
 * The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina
 * Guidelines on the management of stable angina pectoris: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology