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30-Oct-2001
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Arch Hellen Med, 2000, 17(Supplement):129-132
ORIGINAL PAPER
A comparative study of a combination
of antiplatelet drugs versus warfarin
in controlling left ventricular thrombi formation
P. HERAS, G. METAXARIS, I. PAPADAKIS, E. PROKOPAKIS,
S. KARAGIANNIS, G. CHRISOFAKIS, E. TZAGARAKIS
Department of Internal Medicine, General
Hospital of Kos
OBJECTIVE To study the effectiveness
of antiplatelet drugs compared to warfarin in patients with chronic left ventricular
thrombi.
METHOD One hundred patients with dilated cardiomyopathy
and overt ultrasonographic evidence of chronic left ventricular thrombi were
randomly placed on a trial treatment with placebo (group 1), with aspirin (325
mg/day) (group 2), with aspirin 325 mg/day and dipyridamole 200 mg/day (group
3) and finally warfarin (maintaining an INR of 2–3) (group 4). Following a six-month
treatment new ultrasounds were performed.
RESULTS Ultrasonographic absence of reformation
of left ventricular thrombi was established in 4 out of the 22 patients in group
1 (18%), in 6 out of the 25 patients in group 2 (24%), in 15 out of the 25 patients
in group 3 (60%) and in 16 out of the 28 patients in group 4 (56%). Using x2-test,
the differences between patients receiving placebo (group 1) and those receiving
aspirin (group 2) were not statistically significant. Whereas a statistically
significant difference (P<0.05) was revealed between patients receiving aspirin
in combination with dipyridamole (group 3) and those receiving warfarin (group
4) as regards to the placebo group and concerning the inhibition of reformation
of left ventricular thrombi.
CONCLUSIONS The combination of aspirin with dipyridamole
and also warfarin illustrate similar results in preventing reformation of chronic
left ventricular thrombi. Whereas aspirin alone appears to be ineffective in
preventing the formation of chronic left ventricular thrombi.
Key words: Aspirin, Dilated cardiomyopathy, Dipyridamole, Left ventricular thrombi, Warfarin.
