Effects of a selective thromboxane synthetase inhibitor(OKY-046) in patients with coronary artery disease during exercise.

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We studied the levels of thromboxane B2 (TXB2), 6-keto-prostaglandin F1α (6-keto-PGF1α), platelet aggregability, β-thromboglobulin and platelet factor 4 in 30 coronary artery disease (CAD) patients and 21 normal subjects during exercise. During treadmill exercise, 13 of 30 CAD patients reported chest pain. We administered a selective thromboxane synthetase inhibitor (OKY-046) for 2 weeks to 10 CAD patients with exercise-induced chest pain and studied its effects. At rest, the plasma TXB2 levels and platelet aggregation were significantly lower in normal subjects than in CAD patients, and there was no difference between CAD patients with and without exercise-induced chest pain. On treadmill testing, plasma TXB2 levels and platelet aggregation increased significantly only in the CAD patients with exercise-induced chest pain. Plasma 6-keto-PGF1α levels in normal subjects were significantly higher than those in CAD patients both at rest and during exercise. After administration of OKY-046, mean exercise time increased significantly from 7.5 to 8.6min (p<0.001). Plasma TXB2 level and platelet aggregation decreased significantly after OKY-046 administration both at rest and during exercise.These results suggest that a marked increase in TXA2, with only a minimal change in PGI2, during exercise may contribute to exerciseinduced myocardial ischemia, and that OKY-046 is useful in the treatment of CAD patients.
International Heart Journal刊行会の論文