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Persantine (Dipyridamole)
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Persantine

Generic Persantine is a coumarin anticoagulants. Generic Persantine is indicated as an adjunct to coumarin anticoagulants in the prevention of postoperative thromboembolic complications of cardiac valve replacement. Generic Persantine keeps blood flowing smoothly by preventing blood cells from clumping together (coagulating).

Other names for this medication:

Similar Products:
Argatroban, Plavix, Salagen, Arixtra

 

Also known as:  Dipyridamole.

Description

Generic Persantine is a coumarin anticoagulants.

Generic Persantine is indicated as an adjunct to coumarin anticoagulants in the prevention of postoperative thromboembolic complications of cardiac valve replacement. Generic Persantine keeps blood flowing smoothly by preventing blood cells from clumping together (coagulating).

Persantine is also known as Dipyridamole.

Generic name of Generic Persantine is Dipyridamole.

Brand name of Generic Persantine is Persantine.

Dosage

You can take Generic Persantine with or without food.

The recommended Generic Persantine dose is 75-100 mg four times daily.

Try to take this Generic Persantine at the same time each day.

Do not store in the bathroom.

If you want to achieve most effective results do not stop taking Generic Persantine suddenly.

Overdose

If you overdose Generic Persantine and you don't feel good you should visit your doctor or health care provider immediately. Symptoms of Generic Persantine overdosage: warm feeling, flushes, sweating, restlessness, weakness, dizziness.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Persantine are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Generic Persantine if you are allergic to Generic Persantine components.

Be careful with Generic Persantine if you are pregnant, planning to become pregnant, or are breast-feeding.

Be careful with Generic Persantine if you have unstable angina.

Be careful with Generic Persantine if you have had recently sustained myocardial infarction or hypotension.

Be careful with Generic Persantine if you use anticoagulants ("blood thinners"), aspirin, valproic acid.

It can be dangerous to stop Generic Persantine taking suddenly.

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Although the importance of antiplatelet treatment in preventing early bypass occlusion has been clearly recognized, questions regarding the optimal drug regimen remain. To study the efficacy of low-dose aspirin, alone or in combination with dipyridamole, 927 consecutive patients were enrolled in a multicenter, randomized, double-blind, placebo-controlled trial comparing aspirin, 50 mg t.i.d., aspirin, 50 mg t.i.d. plus dipyridamole, 75 mg t.i.d., and placebo. Both aspirin and aspirin plus dipyridamole reduced the occlusion rate of distal anastomoses, but only aspirin plus dipyridamole reduced the number of patients with at least one occluded graft. Logistic regression analysis identified distal vessel diameter, bypassed artery, graft type, and postoperative antiplatelet treatment as independent predictors of graft patency.

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Antiplatelet agents (APA) are used to reduce the risk of major cardiovascular events in various settings. When used for secondary prevention, antiplatelet monotherapy is associated with a relative risk reduction of such ischemic events of 25% compared to a placebo. New strategies are based on dual APA therapy. Aspirin-clopidogrel combination therapy is effective in situations of acute vessel injury such as myocardial infarction, coronary stenting and, possibly, peripheral stenting. GPIIb/IIIa inhibitors and loading doses of clopidogrel also have a place in these acute settings. In contrast, the aspirin-clopidogrel combination has proven disappointing in stable patients with cardiovascular disease, with no beneficial effect and, often, more bleeding events. Combination therapy with aspirin and extended-release dipyridamole may be more beneficial than very low doses of aspirin in ischemic stroke, but its use is limited by adverse effects. Overall, aspirin remains the first-line monotherapy of choice for patients with atherothrombosis, while clopidogrel is a valuable alternative. New antiplatelet strategies are in the pipeline, and clinically relevant laboratory tests of APA response may soon help to tailor treatment.

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The prevalence of severe coronary artery disease in peripheral vascular patients exceeds 50 per cent. It is therefore not surprising that complications of coronary artery disease are the most common causes of mortality following peripheral vascular operations. If the incidence of cardiac complications is to be reduced, it is first necessary to identify patients at risk through screening tests that will reliably detect hemodynamically important coronary occlusive disease. The operative risk can then be reduced by modifying the magnitude of the procedure, taking measures that can enhance the tolerance for a specific operation, or employing a combination of both. Screening methods in current use include risk factor analysis, exercise testing, routine coronary angiography, and dipyridamole thallium-201 scintigraphy. The risk factor approach has the advantage of being widely applicable since it makes use of historical, physical, and electrocardiographic findings that are already familiar to surgeons and anesthesiologists. It is also inexpensive. However, it may overlook the patient who has no symptoms of coronary artery disease, possibly as a result of the sedentary lifestyle imposed by complications of peripheral vascular disease. The electrocardiographically monitored stress test will identify the asymptomatic patient with occult coronary disease and is helpful in predicting operative risk. However, a meaningful test is dependent on the patient's ability to exercise--an activity that is frequently limited by claudication, amputation, or arthritis. Exercise testing also suffers from a lack of sensitivity and specificity when compared with coronary arteriography. Routine preoperative coronary angiography overcomes the exercise limitation of treadmill testing but is not widely applicable as a screening test for reasons of cost and inherent risk. Dipyridamole thallium-201 scanning, on the other hand, is safe and of relatively low cost and does not require exercise. Further, it has a high degree of sensitivity and specificity when compared with coronary arteriography. It appears to be an accurate predictor of postoperative cardiac complications.

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Dipyridamole-echocardiography (echo) testing, exercise stress testing and coronary arteriography were performed in 141 patients with effort chest pain. Patients were separated into 5 groups according to the dose of dipyridamole needed to induce ischemia (0.56 mg/kg over 4 minutes vs 0.84 mg/kg over 10 minutes) and to the time of onset of the asynergy with the small dose (within vs beyond 3 minutes after the end of dipyridamole administration): group 1--early positive response to a small dose (33 patients); group 2--late positive response to a small dose (29 patients); group 3--negative response to a small dose, positive response to a large dose (17 patients); group 4a--negative response to both large and small doses, with significant coronary artery disease (CAD) (32 patients); and group 4b--negative response to small and large doses, without CAD (30 patients). All patients in groups 1, 2 and 3 had significant CAD. The rate-pressure product on exercise stress testing was measured at 0.10 mV of ST-segment shift in patients with a positive response and at peak exercise in patients with a negative response. Rate-pressure product significantly separated group 1 and group 2 from each other (157 +/- 46 and 229 +/- 33 mm Hg X beats/min X 1/100, respectively, mean +/- standard deviation) and from group 3, group 4a and group 4b (284 +/- 40, 290 +/- 51, and 298 +/- 45 mm Hg X beats/min X 1/100); values in the 3 latter groups overlapped.2+ Thus, the dipyridamole-echo test can stratify groups of patients with different levels of ischemia threshold on effort.

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Antiplatelet agents, in this review largely low dose aspirin, have small-moderate benefits when used for prevention of pre-eclampsia. Further information is required to assess which women are most likely to benefit, when treatment should be started, and at what dose.

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As part of a multicentre WHO MONICA-Project the present drug consumption by Warsaw population was assessed (evaluated by DDD). In Warsaw population 2646 inhabitants aged 35-64 years were examined. Ischaemic heart disease was diagnosed in 30% screened persons. Only 39% of subjects were involved in taking cardiovascular drugs. In ischaemic heart disease the drugs used most frequently were pentaerythritol tetranitrate and dipyridamole. The influence of several psychosocial factors on the fact of undertaking of pharmacological therapy was analysed using multivariant logistic function method. Significant relationships were found for age, health self-care self-estimation of health status and fact of medical consultation. Persons with high values of MLF (fifth quintile) underwent drug treatment six time more often, then persons with low values of MLF (first quintile).

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Blood and plasma from 109 patients with atherosclerosis and 70 healthy volunteers were tested to study the rate of prostacyclin (PGI2) hydrolysis. It has been reported that patients with atherosclerosis have the enhanced velocity of PGI2 degradation. The increase in the velocity was more marked in blood than in plasma. The significant negative correlation between antiaggregation effects of pentoxifylline, nifedipine, and dipyridamole and the velocity of PGI2 degradation in the patients was found. These data suggest that the increase of PGI2 biosynthesis by the drugs studied can enhance their antiaggregation effect if processes of PGI2 degradation in blood are not accelerated.

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PET with 13N-ammonia permits the noninvasive quantification of myocardial blood flow (MBF) in humans. The present study was done to assess the reproducibility of quantitative blood flow measurements at rest and during pharmacologically induced hyperemia in healthy individuals.

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A total of 44 patients (39 men) underwent same-day Tc-99m sestamibi stress/rest MPI. High-speed SPECT images were performed within 30 min after conventional SPECT. Stress and rest acquisition times were 16 and 12 min for conventional imaging and 4 and 2 min for high-speed SPECT, respectively. Myocardial counts/min (cpm) were calculated for both conventional SPECT and high-speed SPECT. Images were visually analyzed, and the summed stress score (SSS) and summed rest score (SRS) were calculated. Image quality and diagnostic confidence were qualitatively assessed.

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Analyses of the stroke data after vorapaxar yielded from thrombin-receptor antagonist vorapaxar in acute coronary syndromes (TRACER) and TRA2P clinical trials, and affiliated Food and Drug Administration (FDA) reviews.

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Simultaneous biplane RNA accurately detects wall motion abnormalities frequently missed by single-plane RAO imaging.

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This study was designed to analyze the effects of carbocromene and dipyridamole on the haemodynamic and electrocardiographic side-effects resulting from imipramine infusion in anaesthetised rats and dogs. Imipramine was infused at 1 mg/kg/min until cardiac failure and vascular collapse terminated the experiment at 21 +/- 2.3 min in rats and at 29.5 +/- 2.1 min in dogs. This was characterized by hypotension, bradycardia, intraventricular conduction delay, cardiac tachyarrhythmia and A-V block. Carbocromene (4 mg/kg i.v., followed by 80 micrograms/kg/min) protected the animals against heart failure. This was associated with delayed hypotension and negative inotropy, and lower incidence of heart block. Survival time increased to 37 +/- 1.5 min (P less than 0.05), and 54.2 +/- 2.6 min (P less than 0.02) in rats and dogs, respectively. Dipyridamole (0.5 mg/kg i.v., followed by 80 micrograms/kg/min) failed to decrease imipramine toxicity as judged by the haemodynamic and electrocardiographic parameters and did not alter survival time of imipramine controls. These results suggest that carbocromene is an effective treatment for imipramine-induced cardiovascular collapse and cardiac arrhythmias, the beneficial effects being largely due to metabolic and membrane stabilizing effects. Carbocromene has both therapeutic and prophylactic value and appears to be superior to dipyridamole therapy.

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A total of 415 hypertensive patients underwent rest and stress (exercise in 278 and dipyridamole in 137) gated 99mTc-sestamibi SPECT and prospective follow-up for the composite endpoint of death and acute coronary syndrome. Patients undergoing revascularization were censored. The individual effect of clinical and stress imaging data on outcome was evaluated by Cox regression analysis. Model validation was performed using bootstrap methods adjusted by the degree of optimism in estimates. Survival analysis was performed using the product-limit Kaplan-Meier method.

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Dilazep (i.p.), a coronary vasodilator and an uptake inhibitor of adenosine, dose dependently potentiated acute ethanol-induced motor incoordination in mice. In view of peripheral cardiovascular depressive effects of dilazep, the effect of i.c.v. dilazep (25, 50 and 75 micrograms), and its metabolites, 1,4-bis(3-hydroxypropyl)perhydro-1,4-diazepine (BHPD) (15, 31 and 62 micrograms) and 1-[3-(3,4,5-trimethoxybenzoyloxy)propyl]perhydro-1,4-diazepine (TBPD) (62 and 125 micrograms) on ethanol-induced motor incoordination was studied. Dose-related potentiation of ethanol-induced motor incoordination was noted with dilazep and its metabolites. Whereas dilazep (i.p.) produced no apparent central nervous system (CNS) effects, by i.c.v. route, it caused CNS excitation including tonic-clonic seizures. Adenosine uptake inhibition, Ca2+ entry blockade or direct activation of adenosine receptors was ruled out as the possible mechanism of seizures because dipyridamole, verapamil or N6-(2-phenylisopropyl)-adenosine (R-PIA) administered i.c.v., while potentiating ethanol (i.p.)-induced motor incoordination did not produce seizures. The CNS excitation was minimal with BHPD and none with TBPD. Theophylline pretreatment partially blocked potentiation of ethanol-induced motor incoordination by dilazep and BHPD and not by TBPD. The data suggest dilazep-induced potentiation of ethanol-induced motor incoordination is partially due to central adenosine receptor mechanism and partly due to other yet unknown mechanism(s) and further supported our earlier reports about adenosine involvement in the CNS effects of ethanol. The data also suggest that dilazep (i.c.v.)-induced seizures are due to mechanism(s) other than adenosine uptake inhibition, Ca2+ entry blockade or direct adenosine receptor activation.

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The primary outcome is stroke recurrence and its severity ('ordinal recurrence' based on modified Rankin Scale) at 90 days, with masked assessment centrally by telephone. Secondary outcomes include vascular events, functional measures (disability, mood, cognition, quality of life), and safety (bleeding, death, serious adverse events).

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Eighteen patients with ischaemic peripheral vascular disease were treated for a 5-week period with either 20 mg aspirin daily, 75 mg dipyridamole three times daily or a combination of these two treatments. Before and after 4 weeks' treatment autologous platelet labelling with 111In was carried out and sites of active vascular platelet uptake monitored, and platelet half-life measured. Neither aspirin nor dipyridamole alone had any effect on platelet uptake or on platelet half-life. The combination of aspirin and dipyridamole resulted in a significant decrease in platelet uptake and a nonsignificant trend towards prolongation of platelet half-life. These findings suggest that this combined therapy may be of benefit in the treatment of atherosclerosis in man.

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The feasibility, safety and usefulness of dipyridamole echocardiography (two-dimensional echocardiography and 12 lead electrocardiographic monitoring during dipyridamole infusion, up to 0.84 mg/kg over 10 min) were evaluated in 94 asymptomatic patients 8 to 10 days after uncomplicated acute myocardial infarction. The results were compared with those of symptom-limited treadmill exercise testing and correlated with coronary angiography. Two mechanical patterns of positivity of dipyridamole echocardiography could be identified: 1) a new wall motion abnormality confined to the infarct zone or to the adjacent segments (24 patients), and 2) transient remote asynergy (33 patients). The success rate in recording adequate images during dipyridamole infusion was 100%. Interobserver agreement concerning diagnosis occurred in 89 (93%) of 94 patients. Dipyridamole echocardiography was well tolerated; no complication was observed during or after the test. Seventy-three patients underwent coronary angiography within 6 weeks after acute myocardial infarction. Transient remote asynergy on echocardiography was present in 27 of 40 patients with multivessel disease and in none of 33 patients without multivessel disease. Results of treadmill exercise testing were positive in 28 patients with multivessel disease and 8 patients without multivessel disease. Thus, the sensitivity of dipyridamole-induced transient remote asynergy was 68% compared with 52% for treadmill testing (p less than 0.05); specificity was 100% and 72%, respectively (p less than 0.005). The overall accuracy of dipyridamole echocardiography (81%) was higher than that of dipyridamole stress electrocardiography (63%) or exercise electrocardiography (60%) (p less than 0.02). It is concluded that dipyridamole echocardiography is a useful, feasible and inexpensive nonexercise-dependent test for detecting the extent of coronary artery disease early after acute myocardial infarction.

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Patients with essential arterial hypertension demonstrate abnormal vasodilator capacity either during increased cardiac metabolic demand or during pharmacological vasodilation. Structural and functional damage to the coronary microcirculation has been proposed as one of the major causes of impaired coronary reserve in this disease. To assess the role of microvascular impairment in regional myocardial blood flow (MBF), 27 patients with essential hypertension were evaluated by dynamic positron emission tomography (PET) at rest, during atrial pacing and after dipyridamole infusion and compared with 13 healthy subjects. All patients had normal coronary arteries, 17 had moderate to severe hypertension and 10 had mild hypertension. Baseline mean MBF of 0.97 +/- 0.25 ml/min/g was significantly increased to 1.60 +/- 0.38 during atrial pacing and 2.35 +/- 0.95 after dipyridamole infusion (p < 0.01); however, mean flow during atrial pacing and after dipyridamole infusion was significantly lower than in healthy subjects (2.15 +/- 0.73 and 3.71 +/- 0.86 ml/min/g, p < 0.05 and p < 0.01, respectively). The MBF response to atrial pacing and dipyridamole infusion was similarly depressed in patients with mild and severe hypertension. The study was repeated after 6 months of antihypertensive treatment with the calcium antagonist verapamil or the angiotensin converting enzyme (ACE) inhibitor enalapril in a subgroup of 20 patients as part of a randomised, single-blind clinical trial. This study is still in progress; the initial 16 patients treated with verapamil or enalapril showed an obvious improvement in MBF values during atrial pacing and after dipyridamole infusion after 6 months of therapy (mean MBF: 2.10 +/- 0.64 and 2.99 +/- 1.63 ml/min/g, respectively, p < 0.05 vs pretreatment values). In conclusion, obvious impairment of MBF during atrial pacing and after dipyridamole infusion was observed in hypertensive patients with normal coronary arteries and this appeared unrelated to the severity of hypertension. Therapy with verapamil or enalapril improved coronary reserve and MBF response to an increase in myocardial oxygen demand.

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The results of our study demonstrate that the transient dilation index does not differ when patients undergo exercise stress test on a treadmill or pharmacological stress by dipyridamole.

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We tested the practicability of dipyridamole myocardial nitrogen-13 ammonia positron emission tomography (dipyridamole (13)NH(3 )PET) for the perioperative risk assessment of coronary artery disease (CAD) in a cohort of patients with severe chronic obstructive pulmonary disease (COPD) undergoing lung volume reduction surgery (LVRS). Twenty consecutive LVRS candidates, 13 men and 7 women (mean age 57+/-2 years), without symptoms of CAD were prospectively studied by dipyridamole (13)NH(3 )PET. Side-effects and overall tolerance were assessed by a questionnaire and visual analogue scale. Repeated pulmonary function tests were performed before and 4, 12, 16 and 30 minutes after dipyridamole injection. All dipyridamole (13)NH(3 )PET studies were negative for CAD. Seventeen patients underwent LVRS without cardiac complications; three patients did not undergo LVRS for other reasons. Nine patients suffered intolerable dyspnoea requiring i.v. aminophylline. Mean FEV(1) decreased significantly after dipyridamole infusion: in nine patients the reduction in FEV(1)exceeded 15% from baseline. We found that dipyridamole is not well tolerated and causes significant bronchoconstriction in patients with severe COPD. Although all dipyridamole-induced side effects can be promptly reversed by aminophylline, dipyridamole cannot be recommended as a pharmacological stress in this setting.

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MPR and MVR in MS and SS territories were significantly lower than those of NS territories (p < 0.05 for all). Logistic regression analysis identified MPR∙MVR as the best predictor of ≥50% coronary lesion than MPR or MVR alone.

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Feasibility of digital exercise echocardiography was 84%; 8 of 88 remaining patients had a nondiagnostic exercise echocardiographic test (inadequate exercise or imaging). In 80 patients with feasible and diagnostic digital exercise echocardiography, sensitivity, specificity and accuracy were, respectively, 89%, 91% and 90%. Eighty of the 104 patients underwent transesophageal atrial pacing and dipyridamole echocardiography. Feasibility of the alternative stress procedures was 77% for transesophageal atrial pacing and 96% for dipyridamole. In 60 patients successfully undergoing both alternative stress procedures, sensitivity and specificity were 83% and 76% for atrial pacing and 43% and 92% for dipyridamole echocardiography, respectively. In the group of 24 patients with nondiagnostic exercise echocardiography and consequent indication to alternative stress procedures, accuracy of transesophageal atrial pacing was higher than that of dipyridamole echocardiography (73% vs. 45%, p = 0.06).

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The aim of this study was to compare the diagnostic value of exercise stress testing, Thallium 201 myocardial scintigraphy or after administration of dipyridamole and left ventricular angioscintigraphy performed either during a static (handgrip) or dynamic exercise (bicycle ergometry) for the positive diagnosis of stenosing coronary artery disease. The exercise angioscintigraphy was performed at equilibrium with 99m Tc red blood cell labelling. The global ejection fraction and that of seven radial segments of the left ventricle were measured, the data being recorded within a period of 2 minutes. The handgrip consisted in compressing a dynamometric ball at 1/3 maximal force for 3 minutes, with both hands; the ergometric exercise was increased by 30 Watt 2 minute increments until a positive ECG or 85% of the theoretical maximal heart rate for age was obtained. Normal subjects (n = 29) increased their global (+ 8%) and regional ejection fractions in each of the seven segments (p less than 0.05) during ergometric exercise: there was no significant change of global (-3% NS) or segmental ejection fractions during the handgrip exercise. In the coronary group (at least one greater than 70% stenosis) (n = 61) the fall in global ejection fraction was the same (-14%) with both forms of exercise; a similar fall in the segmental ejection fraction in the territory distal to the stenosis was observed with the handgrip (-22%) and bicycle ergometry (-28% NS). Dynamic exercise testing seemed superior to handgrip exercise. Therefore, the finding of an abnormal global ejection fraction on exercise (i.e. either a global ejection fraction less than the lower limit of normal on exercise, or lower than the global ejection fraction at rest), or of an abnormal regional ejection fraction (i.e. either a regional ejection fraction less than the lower limit of normal over at least 3 segments, or a regional ejection fraction on exercise lower than the regional ejection fraction at rest over at least 3 segments) detected coronary artery disease with a sensitivity of 94% and a specificity of 72%. Dynamic exercise angiography seemed to be more sensitive than maximal ECG stress testing (94% compared to 64%) more rapidly positive (p less than 0.05), as sensitive (94% compared to 83% NS) than Thallium myocardial scintigraphy, but less specific (72% compared to 90%, p less than 0.05), and as unspecific as ECG stress testing.(ABSTRACT TRUNCATED AT 400 WORDS)

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The evaluation of myocardial perfusion and tissue characteristics gives useful information regarding the indication for surgery. In the present study, two-phase contrast enhanced electron beam computed tomography (EBT) was used to quantitatively examine myocardial perfusion and the tissue characteristics of the left ventricular (LV) myocardium in congenital aortic stenosis (AS). The AS group comprised 15 patients and the control group had 14 non-AS patients. Myocardial ischemia and tissue characteristics were evaluated by the ratio of the incremental CT number of the myocardium (M) and the lumen (L) of the LV (M/L) in, the early phase with and without dipyridamole (Dp) loading and in the late phase after enhancement (respectively). In a comparison between the AS group and the controls, mean early M/Ls were significantly lower in the AS group than in the controls (20+/-5% vs 37+/-10%, p<0.01) and mean late M/Ls in the AS group were also significantly lower (47+/-11% vs 62+/-13%, p<0.01). In the AS patients, early M/Ls in the subendocardial and apical regions were especially lower than those of other segments, but the late M/Ls in these segments were inversely higher than those of other segments. These results suggest 2 things: (1) the existence of latent LV myocardial ischemia in AS patients, which is probably because of a hypertrophied LV wall, in turn caused by afterload, and (2) the presence of more myocardial ischemia and interstitial fibrosis in the subendocardial and apical regions of the AS heart. Using Dp loading for the AS patients increased the clarity of the contrast images. Contrast-enhanced EBT is useful for evaluating myocardial characteristics and perfusion in AS, and gives new insight into the LV wall characteristics in AS, as well as an indication for surgical correction of congenital AS.

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Vascular injury during aortocoronary vein bypass graft surgery and arterial angioplasty initiates platelet thrombus deposition and mandates antithrombotic therapy, starting before the procedures to maximize protection against occlusion. This has been shown in studies in animals and in patients undergoing aortocoronary vein bypass graft operation where dipyridamole therapy was started before the operation, heparin was given intraoperatively and combined dipyridamole and aspirin therapy was started 7 hours after operation and markedly reduced vein graft occlusion in patients with grafts at both high and low risk for occlusion without increasing bleeding. Other alternative regimens, particularly preoperative dipyridamole followed postoperatively with aspirin alone, offer a promising future. Therapy should be continued for at least 1 year and perhaps indefinitely. Control of coronary risk factors appears important for long-term therapy to try to retard the atherosclerotic and occlusive process that leads to approximately 50% vein graft attrition by 10 years after operation. The possible role of cod liver oil and internal mammary artery bypass is discussed. Arterial angioplasty appears to cause deep arterial injury that activates both platelets and the coagulation system. These potentiate each other to form macroscopic mural thrombus within 1 hour in more than 90% of arteries that manifested deep arterial injury in pigs. Acute platelet thrombus deposition was retarded but not eliminated by only certain platelet-inhibitor agents. Implications for ongoing trials, current empiric therapy and future therapy are discussed.

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A consistent FFR was obtained in all patients. Both the sensor built and the echo built FFR identifiy pts with normal or abnormal contractile reserve. The best cut-off value of the sensor built FFR was 15.5 g * 10-3 (Sensitivity = 0.85, Specificity = 0.77). Sensor built FFR slope and shape mirror pressure/volume relation during stress. This approach is extendable to daily physiological exercise and could be potentially attractive in home monitoring systems.

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Mean FFR and DST were 0.76 +/- 0.14 and 74 +/- 15%. SPECT showed no significant correlation with both FFR and DST with Kendall's coefficiency of 0.28 (p = 0.05) and 0.13 (p = 0.35). The sensitivity and specificity of SPECT to detect functionally and morphologically significant residual stenosis were 92%, 31% and 83%, 29%.

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BIBW22BS was 20- to 100-fold more potent than dipyridamole in the reversal of resistance in the Pgp-positive sublines. Reversal of resistance was obtained in a dose-dependent manner and was complete at concentrations of 0.5-2.5 microM. At non-toxic, equimolar concentrations of 1.0 microM BIBW22BS showed higher modulating potency than the calcium-channel blockers. BIBW22BS did not affect resistance in the non-Pgp sublines. BRO/mdr1.1 s.c. xenografts have stable multidrug-resistance characteristics upon serial transplantation. BIBW22BS, vincristine, or doxorubicin as single agents were not effective in vivo, while the addition of BIBW22BS could significantly reduce the tumor growth expressed as the T/C% of vincristine from 109% to 48% and that of doxorubicin from 55% to 32%. However, reversal of vincristine resistance in BRO/mdr1.1 xenografts was not complete when compared to the efficacy of vincristine in BRO xenografts.

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Myocardial blood flow (MBF) at rest and during dipyridamole-induced hyperemia was quantified in 10 transplant patients (group A) during an acute, biopsy-proven rejection episode and again after successful immunosuppressive treatment and in 6 transplant patients (group B) without prior rejection episode. In group A patients, MBF during rejection averaged 1.7 +/- 0.3 mL.min-1.g-1 at rest and 2.5 +/- 0.9 mL.min-1.g-1 during hyperemia; after recovery, MBF at rest had declined to 1.2 +/- 0.3 mL.-1.g-1 (P < .001) but had increased to 3.9 +/- 1.1 mL.-1.g-1 (P < .001) during hyperemia. Flows after recovery from rejection were similar to those in the group B patients (0.9 +/- 0.2 and 3.9 +/- 0.7 mL.min-1.g-1). Flow reserve in the group A patients was only 1.5 +/- 0.5 during rejection but improved to 3.4 +/- 0.9 at recovery (P < .001) and thus remained lower than in the control patients (4.5 +/- 0.7, P < .05). Minimal coronary resistance during dipyridamole vasodilation was elevated during rejection (40 +/- 11 mm Hg.mL-1.min-1.g-1); after recovery, it no longer differed from that in the group B patients (26 +/- 11 versus 22 +/- 4 mm Hg.mL-1.min-1.g-1). MBF during rejection was increased relative to cardiac work, as demonstrated by significantly higher ratios of blood flow to rate-pressure product than those at recovery and in the control patients.

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To map precise myocardial perfusion anatomy, we correlated detailed coronary arteriographic anatomy for every coronary artery and all secondary branches in the heart that had flow-limiting stenosis with corresponding specific, circumscribed, myocardial perfusion defects by positron emission tomography. Eight hundred ninety-five patients with abnormal coronary arteriograms showing any visible coronary artery narrowing of greater than 10% diameter stenosis underwent positron emission tomography perfusion imaging at rest and after dipyridamole stress; the data obtained were processed automatically into 3-dimensional topographic displays of relative radionuclide uptake in anterior, septal, left lateral, and inferior quadrant views, without attenuation artifacts, depth-dependent resolution, or spatial distortion of polar displays. The selection criterion for detailed anatomic analysis was the presence of a discrete, localized, moderate to severe, dipyridamole-induced perfusion defect, defined by automated algorithms as 1 quadrant view outside 2 SDs of healthy control subjects with which a specific stenotic coronary artery and/or its secondary branches could be correlated unequivocally on the coronary arteriogram for mapping precise perfusion anatomy, not for determining sensitivity or specificity. Because the anatomy of myocardial perfusion is inherently not statistical data, the results are presented as a summary atlas and series of individual cases that illustrate myocardial perfusion anatomy. Because the patterns of myocardial perfusion anatomy were derived from a large number of subjects, the atlas provides generalized information, not previously published, that correlates detailed arteriographic anatomy with perfusion anatomy including secondary diagonal, marginal, and posterior descending branches of the coronary arteries.

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persantine 25 mg 2016-12-30

The renal handling of two anticancer (a-Ca) pyrimidines 5-fluorodeoxyuridine (FUdR) and 5-fluorouracil (5-FU) was investigated in clearance experiments in CF-1 mice using specific inhibitors of classical renal transport systems. The 5-FU was derived from the metabolism of FUdR. Based buy persantine on the FUdR:inulin clearance ratio and 5-FU:inulin clearance ratio, it was determined that FUdR was secreted into renal tubules while 5-FU underwent reabsorption. The secretion of FUdR was inhibited by cimetidine and dipyridamole but not by probenecid or phloridzin. While the clearance ratio of 5-FU:inulin was significantly reduced by phloridzin, it (i.e., the ratio) was not affected by cimetidine, dipyridamole, or probenecid. The impact of two calcium channel blockers, diltiazem (DZM) and verapamil (VER), on the renal handling of FUdR and 5-FU was also examined. VER increased the secretion of FUdR without affecting the reabsorption of 5-FU while DZM slightly decreased the secretion of FUdR and prevented the reabsorption of 5-FU. These data suggest that the organic cation carrier and a dipyridamole-sensitive nucleoside transporter are involved in the renal excretion of FUdR; that the renal transport of both FUdR and 5-FU is associated with the calcium channel; and that 5-FU utilizes, at least in part, the glucose transporter for its reabsorption.

persantine generic names 2015-11-05

The management of Henoch-Schönlein purpura nephritis (HSPN) is controversial. It has been revealed that some patients develop end-stage renal disease and aggressive treatment with drugs such as steroids is increasing, and some of them may be overzealous. At our institutes buy persantine , our treatment decisions are based on the clinical and pathological severity of the case in an attempt to limit the indications for aggressive therapies such as steroids and immunosuppressive agents. Here, we retrospectively examined the efficacy of treatment for HSPN. Renal biopsy was performed in patients with nephrotic syndrome or persistent proteinuria for more than 3 months and patients were classified by treatment. Patients (n=31) with moderately severe HSPN (histological grade I-III and serum albumin [Alb] >2.5 g/dl) were treated with angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers. Patients (n=19) with HSPN exceeding grade III or Alb ≤ 2.5 g/dl received combination therapy comprising prednisolone, immunosuppressants, warfarin, and dipyridamole. All patients showed resolution of proteinuria without renal dysfunction during the observation period (3.76 ± 0.37 years). Our findings support those of some earlier reports that treatment strategies for HSPN should depend on the histological and clinical severity. Furthermore, aggressive therapies, particularly combination therapies, are unnecessary for moderate-severe HSPN.

persantine overdose 2015-05-10

Left ventricular wall motion was assessed at baseline and peak dobutamine dose in a standard fashion. Wall motion was scored and indexed using a 16-segment model. A positive DSE was defined as failure of augmentation, new or worsening of baseline wall motion abnormalities in two or more contiguous segments. Myocardial perfusion studies after DT were performed according to buy persantine conventional method. A positive DT was defined as a reversible perfusion defect, increased lung uptake, and/or transient left ventricular dilatation. Complications were defined as myocardial infarction or cardiac death occurring as a result of the operation, or need for revascularization before surgery.

persantine drug classification 2016-03-03

A 77-year-old woman with suspected coronary artery disease underwent an oral dipyridamole/thallium-201 myocardial imaging study. Approximately 75 minutes after ingestion of dipyridamole 300 mg suspension, the patient developed chest pain, hypotension, nausea, and diaphoresis. An electrocardiogram revealed ST-T wave changes suggestive of inferior ischemia. Appropriate therapeutic measures, including aminophylline and nitroglycerin, were instituted. Delayed thallium images revealed reversible ischemia in the anteroseptal and posterobasal regions with a fixed defect in the inferobasal region. Cardiac enzyme studies were also indicative of acute myocardial injury. The patient subsequently underwent coronary arteriography buy persantine and four-vessel coronary artery bypass grafting and was discharged without further complication. This report raises concerns about the potential danger of dipyridamole in patients with severe coronary artery stenosis and collateral circulation. Prophylactic aminophylline should be considered in these patients.

persantine 75 mg 2017-11-18

Of the elderly group who were judged to be fit to exercise to 85% of maximum predicted heart rate, nearly half failed to reach this level. In contrast, the younger patients were able to achieve this buy persantine level in 67% of tests. Supplementation with modest exercise reduced most of the pharmacologically related adverse effects. The elderly group was not protected from atrioventricular block as effectively as the younger group by additional exercise in the adenosine stress test. Ischemic electrocardiographic changes in the pharmacologic stress test were as frequent as in the exercise stress test when modest supplementary exercise was added to the pharmacologic protocol. There were no deaths, myocardial infarction, or other major complications. These observations suggest that exercise and pharmacologic stress tests are safe in the elderly, including those patients more than 75 years old.

persantine medication classification 2016-12-19

Protein glycosylation is important for nucleoside transport, and this has been demonstrated for the human equilibrative nucleoside transporter-1 (hENT1). It is not known whether glycosylation affects the functions of hENT2 or where hENT2 is glycosylated. We address these questions using N-glycosylation mutants (N48D, N57D, and N48/57D) and demonstrate that hENT2 is glycosylated at Asn(48) and Asn(57). Our results show that although the apparent affinities for [3H]uridine and [3H]cytidine of the mutants were indistinguishable from those of the wild-type protein, N-glycosylation was required for efficient targeting buy persantine of hENT2 to the plasma membrane. All mutants had a two- to threefold increase in IC(50) for dipyridamole. N57D and N48/57D, but not N48D, also had a twofold increase in IC(50) for NBMPR. We conclude that the relative insensitivity of hENT2 to inhibitors is primarily due to its primary structure and not to glycosylation. Glycosylation modulates hENT1 function, but is not required for hENT2.

persantine dosage chart 2015-08-18

The noninvasive diagnosis of coronary artery disease in the elderly can occasionally be difficult. Intravenous dipyridamole-thallium imaging is a potentially useful diagnostic test to determine presence and severity of coronary disease; however, the safety of the procedure has not been determined in an older population. The side effect profile and frequency of severe ischemic responses after 0.56 mg/kg of intravenous dipyridamole were compared in 101 patients greater than or equal to 70 years old and 236 patients less than 70 years old. There were no side effects in 64% and 62% of patients greater than or equal to 70 and less than 70 years old, respectively (p = NS). Among the 337 patients tested, there were no complications of myocardial infarction or death. The most common cardiac side effect was chest pain, which occurred in 21 (21%) of the 101 patients aged greater than or equal to 70 years and in 64 (27%) of the 236 patients less than 70 years (p = NS). Aminophylline was required to reverse cardiac or noncardiac side effects in 15 (15%) and 36 (15%) of the patients greater than or equal to 70 and less than 70 years old, respectively (p = NS). A severe ischemic response occurred in 2% and 2.5% of patients greater than or equal to 70 and less than 70 years old, respectively (p = NS). The sensitivity of intravenous dipyridamole-thallium imaging for obstructive coronary artery disease was 86% (25 of 29) and 83% (68 of 82) in older and younger patients, respectively buy persantine (p = NS); the specificity was 75% (6 of 8) and 70% (16 of 23), respectively (p = NS). Thus, intravenous dipyridamole-thallium imaging is a safe noninvasive method for assessment of older patients with obstructive coronary disease; its side effect profile and diagnostic accuracy are similar to those seen in younger patients. The technique is associated with severe ischemic responses in only a small minority of patients.

persantine 50 mg 2015-06-15

From the Institute of Clinical Physiology, National Research Council, Pisa Italy stress echo data bank (1983-1998), buy persantine we selected 46 patients with two repeated EET, DET and coronary angiography (CA) in two different hospital admissions (46+/-30 months). A priori, angiographic progressors were defined as any stenosis progression to occlusion and/or any stenosis >30% with >20% stenosis progression measured by visual and quantitative CA. EET progressors were defined as a previous negative test becoming positive or as a positive test with decrease in ischemic threshold response in the second test. DET progressors were defined as previous negative test becoming positive or as a positive test with a more severe ischemic response in the second test.

persantine drug 2016-09-24

Most patients with high cardiac risk should proceed with coronary angiography. Patients with low cardiac risk can proceed to surgery without noninvasive testing. For intermediate-risk patients, consideration may be given to further stress testing buy persantine prior to surgery; however, in most patients, proceeding to surgery with perioperative beta-blockade is an acceptable alternative.

persantine brand name 2017-07-30

Using PET, 156 segments were identified with reversible ischaemia and 324 as non-ischaemic. The ischaemic segments were found on BOLD MRI to have an average signal change between rest and stress of -16.7% compared to -14% in the non-ischaemic segments (p=0.04). The average wall thickening was 7.8 mm in the buy persantine ischaemic segments compared with 9.5 mm in the non-ischaemic segments (p<0.0001).

persantine drug interactions 2016-08-22

CFR is impaired in buy persantine patients with ESRD suggesting that coronary microvascular dysfunction, an early finding of atherosclerosis, is evident in these patients. Although associated with a decreased CFR compared with controls, renal transplant on the other hand seems to have a favorable effect on coronary microvascular function.

cost of persantine 2016-01-24

Antihypertensive Long-term Therapy with Isradipine/Improvement of coronary flow reserve in patients with arterial and microvascular angina In patients with arterial hypertension coronary flow reserve is often impaired due to left ventricular (LV) hypertrophy and alterations of the coronary microcirculation. Experimental and clinical studies have shown that calcium channel blockers can induce regression of myocardial hypertrophy. Objective of the present study was to see whether chronic antihypertensive treatment with calcium channel blockers can improve the diminished coronary reserve in patients with arterial hypertension and microvascular angina pectoris. Fifteen hypertensive patients with microvascular angina (61 +/- 7 years, normal coronary angiogram, mild LV-hypertrophy) were treated with isradipine (CAS 75695-93-1) (5.3 +/- 0.9 mg/d) for 12 +/- 2 months. Before and after therapy (after a washout period of 1 week) coronary flow was quantitatively measured by the gas chromatographic Argon method. Coronary reserve was calculated as the quotient of coronary resistance under baseline conditions and after dipyridamole (0.5 buy persantine mg/kg i.v.). Under isradipine therapy systolic blood pressure was lowered from 165 +/- 20 to 140 +/- 13 mmHg (p < 0.01) and diastolic blood pressure from 98 +/- 8 to 88 +/- 6 mmHg (p < 0.01). The LV muscle mass index decreased by 10% from 154 +/- 33 to 139 +/- 28 g/m2 (p < 0.05). Baseline coronary blood flow (81 +/- 13 versus 83 +/- 16 ml/min x 100 g, n.s.) was identical before and after therapy. There were also no differences in coronary perfusion pressure, heart rate, myocardial oxygen consumption and arterio-coronary venous oxygen difference before and after therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

persantine cost 2016-10-30

The known risk of embolic events in patients with recurrent or chronic atrial fibrillation makes it mandatory to recommend oral anticoagulation in patients with rheumatic mitral valve disease, specially mitral stenosis to maintain an INR between Lopid Mg 2.0 and 3.0. If despite this treatment recurrent embolism occurs, the dose of oral anticoagulants should be increased (INR between 2.5 and 3.5) or dipyridamole (200 to 400 mg/day) or aspirin (160 to 320 mg/day) should be added to dicoumarinic drugs. In patients that must be cardioverted either electrically or pharmacologically and who have been on atrial fibrillation for more than 2 days, oral anticoagulation should be maintained for 3-4 weeks before cardioversion and for 3-4 weeks after regaining sinus rhythm. Transesophageal echocardiography may enable us to identify the group of patients with low risk for an immediate cardioversion. In patients under 60 years of age with atrial fibrillation and no evidence of associated cardiovascular abnormality (lone atrial fibrillation) the embolic risk is very low and antithrombotic therapy is probably not needed. In subjects over 60 years of age with a low risk profile (absence of previous stroke, heart failure or systemic hypertension) aspirin (300-325 mg a day) seems to offer sufficient protection against embolic events. In patients at a higher embolic risk (history of previous cerebral ischemic attacks, heart failure of left ventricular dysfunction, systemic hypertension) oral anticoagulation unless contraindicated, should be recommended (INR 2.0-3.0). The role of other antithrombotic agents such as ticlopidine or triflusal to prevent embolic events in patients with atrial fibrillation is unknown.

persantine dose 2016-05-13

A comparison between adenosine and dipyridamole was made in the following areas: concordance in interpretation Strattera Recommended Dosage of 201Tl scintigrams, cardiac and noncardiac 201Tl uptake and clearance, hemodynamic and electrocardiographic changes, and adverse effects.

persantine tablets 2016-12-31

To our knowledge this software represents the first experience of a common computerized program for Cheap Propecia Usa echo archiving and reporting carried out at national level.

persantine generic name 2015-10-20

99mTc-labeled sestamibi myocardial tomography in conjunction with intravenous dipyridamole stress is a safe and sensitive method for the detection of coronary artery disease. The diagnostic accuracy of dipyridamole stress 99mTc-labeled sestamibi SPECT for the detection of coronary artery disease is similar to that reported for exercise stress Imitrex Injections Dosage 99mTc-labeled sestamibi tomography, making this a suitable alternative for the evaluation of patients who are unable to exercise adequately.

persantine 25mg tabs 2016-04-30

Patients with acute ischaemic stroke taking antithrombotic Nexium Daily Dose medications at hospital admission have improved functional outcomes. No interaction is noted between use of these medications and outcome following thrombolysis. This large prospective cohort study is consistent with previous published reports, and supports the notion that pre admission antithrombotics may mitigate brain injury during acute stroke.

persantine dosing chart 2017-12-10

99Tc-MIBI myocardial perfusion imaging Pamelor Overdose Effects is a reliable non-invasive method for detecting coronary artery disease in patients with valvular disease and so as to draw up suitable operation programs for them.

persantine 10 mg 2016-08-31

The hemodynamic effects of ATP and adenosine (i.v. infusions) were studied in dogs in parallel with quantitative determination of purines in plasma by HPLC. In two experiments, infusion were performed during treatment with dipyridamole, an uptake inhibitor of adenosine. A 50-60% reduction of mean arterial blood Luvox Reviews Australia pressure (MABP) was induced by both ATP and adenosine at infusion rates ranging between 17-290 mumoles/min. Cardiac output was unaffected by the purine infusions, indicating that the reduction of MABP was caused by a reduction of the systemic vascular resistance. Elevated ATP and adenosine concentrations were seen in venous plasma (pulmonary artery) during infusion, while only approximately 10% recovered ATP had been degraded to adenosine. On the other hand, in arterial plasma, virtually all nucleotides had been eliminated whereas the adenosine concentrations in plasma ranged between 5 and 20 microM. The magnitude of the vasodilatation was strictly related to the arterial plasma adenosine level irrespective of whether ATP or adenosine was infused. Thus, adenosine probably mediates the vasodilatory effect of ATP.

persantine medication 2016-06-25

Patients were referred by cardiologists and randomized to PET or SPECT by the imaging center. A total of 210 patients (106 women, 104 men) were enrolled in this study, with 105 imaged by dual-isotope SPECT and 105 imaged by 82Rb PET. Rest/stress Depakote Pills scanning was performed using dipyridamole. The effects of sex, prior history of CAD, and instrumentation on the detection of positive scans were determined using multiple logistic regression analysis with positive scans as the endpoint.

persantine and alcohol 2016-01-02

The presence of defects on Indocin Max Dose rest thallium 201 myocardial scintigraphy, reversible after dipyridamole infusion, was already demonstrated in myocardial localization of sarcoidosis. The present study compared the respective efficiency of a new tracer of myocardial blood flow, 99mTc sestamibi (sestamibi), vs thallium 201 (TI) for the diagnosis and follow-up of myocardial sarcoidosis.

persantine drug class 2017-12-29

We administered dipyridamole, an adenosine reuptake inhibitor, to 12 outpatients with DSM-III-R anxiety disorders (2 patients with generalized anxiety disorder, 10 patients with panic disorder). Dipyridamole was administered at a flexible dose in a single-blinded fashion following a placebo washout phase and elimination of placebo responders. The mean duration of active treatment with dipyridamole was Zovirax 200mg Dosage 46 days (range 21-88 days); the mean peak dose of dipyridamole was 202 +/- 55 mg/day (range 100-300 mg/day). Symptom ratings were completed at regular intervals by the patient and by a research nurse unaware of the treatment condition. Clinically significant improvement in anxiety symptoms was not demonstrated. The implications of these findings for an adenosinergic dysfunction model of panic disorder are discussed.