Thromboxane A2 in vasotonic angina pectoris: evidence from direct measurements and inhibitor trials.

Robertson RM, Robertson D, Roberts LJ, Maas RL, FitzGerald GA, Friesinger GC, Oates JA
N Engl J Med. 1981 304 (17): 998-1003

PMID: 7010173 · DOI:10.1056/NEJM198104233041703

Thromboxane A2 (TxA2), an arachidonic acid metabolite causing vasoconstriction and platelet aggregation, is a putative mediator of coronary-artery vasospasm. To determine whether platelet-released TxA2 causes coronary arterial vasospasm, we measured plasma thromboxane B2 (TxB2, the inactive hydration product of TxA2) in the radial-artery and coronary-sinus blood of seven patients and performed therapeutic trials of antiplatelet agents in nine. Although coronary-sinus TxB2 levels rose from the base line approximately fivefold with spontaneous ischemia, samples drawn early in ischemia showed no rise over base-line values. Although a 150 mg dose of aspirin reduced urinary dinor-TxB2 levels by over 75 per cent, it had no effect on the course of the chronic recurrent form of angina pectoris due to vasospasm ("vasotonic angina"). Similarly, indomethacin had no effect on the frequency or duration of ischemia. TxA2 is unlikely to cause vasotonic angina, but it may be released during coronary vasospasm.

MeSH Terms (21)

Adult Angina Pectoris Angina Pectoris, Variant Arteries Aspirin Clinical Trials as Topic Coronary Circulation Coronary Vessels Double-Blind Method Female Humans Indomethacin Ischemia Male Middle Aged Recurrence Thromboxane A2 Thromboxane B2 Thromboxanes Time Factors Veins

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