Prevention of myocardial infarction and stroke in patients with intermittent claudication; effects of ticlopidine. Results from STIMS, the Swedish Ticlopidine Multicentre Study

J Intern Med. 1990 May;227(5):301-8. doi: 10.1111/j.1365-2796.1990.tb00164.x.

Abstract

The Swedish Ticlopidine Multicentre Study (STIMS) was a double-blind placebo-controlled trial designed to determine whether ticlopidine, a platelet antiaggregatory agent, reduces the incidence of myocardial infarction, stroke and transitory ischaemic attacks in patients with intermittent claudication. A total of 687 patients was monitored for a minimum of 5 years or until an end-point was reached. The number of end points (99 vs. 89), analysed according to the intention-to-treat principle, was 11.4% lower in the ticlopidine group (P = 0.24). The mortality rate was 29.1% lower in the ticlopidine group (64 vs. 89, P = 0.015); this observation could be accounted for by a reduced mortality from ischaemic heart disease. On-treatment analysis showed there to be significantly fewer end points in the ticlopidine group (47 vs. 76, P = 0.017). Diarrhoea was the most common side-effect. Reversible leucopenia or thrombocytopenia was reported in seven patients on ticlopidine. It is concluded that the high morbidity and mortality from cardio- and cerebrovascular disease in patients with intermittent claudication can be reduced by long-term treatment with ticlopidine.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cerebrovascular Disorders / mortality
  • Cerebrovascular Disorders / prevention & control*
  • Coronary Disease / mortality
  • Female
  • Humans
  • Intermittent Claudication / drug therapy*
  • Ischemic Attack, Transient / prevention & control
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Myocardial Infarction / prevention & control*
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Ticlopidine / adverse effects
  • Ticlopidine / therapeutic use*

Substances

  • Ticlopidine