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Effect of Triflusal on Primary Vascular Dysregulation Compared with Aspirin: A Double-Blind, Randomized, Crossover Trial.

Shin S, Kim KJ, Cho IJ, Hong GR, Jang Y, Chung N, Rah YM, Chang HJ - Yonsei Med. J. (2015)

Bottom Line: We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin.The use of triflusal resulted in a greater improvement in CISS score (44.5±18.4 vs. 51.9±16.2; p<0.001) and in mean radial peak systolic velocity (69.8±17.2 vs. 66.1±16.4; p=0.011) compared to aspirin.Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

ABSTRACT

Purpose: Primary vascular dysregulation (PVD) is a condition in which the response to cold temperature or external stimuli is abnormal. We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin.

Materials and methods: Eighty-eight PVD patients (54% female, 56±8 years) were randomly selected to receive either triflusal (300 mg, b.i.d.) or aspirin (150 mg, b.i.d.) for a period of 6 weeks followed by crossover. PVD was defined as both red-blood-cell standstill in video-assisted microscopic capillaroscopy during cold stimulation using carbon dioxide gas and a score of more than 7 points in a validated questionnaire. Efficacy of treatment was assessed by 1) cold intolerance symptom severity (CISS) score, 2) finger Doppler indices, and 3) indocyanine green perfusion imaging.

Results: The use of triflusal resulted in a greater improvement in CISS score (44.5±18.4 vs. 51.9±16.2; p<0.001) and in mean radial peak systolic velocity (69.8±17.2 vs. 66.1±16.4; p=0.011) compared to aspirin. Furthermore, significant differences were also observed in perfusion rates on indocyanine green perfusion imaging between triflusal and aspirin (45.6±25.8 vs. 51.6±26.9; p=0.020).

Conclusion: Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.

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Related in: MedlinePlus

Primary, secondary, and exploratory endpoints. (A) Although the CISS scores of Aspirin and Triflusal groups both decreased by week 6, only the CISS score of Triflusal group decreased further by week 14 after cross-over, while that of Aspirin group remained unchanged. Overall, both Aspirin and Triflusal were effective in relieving symptoms, but Triflusal group had significantly more improved symptoms compared with Aspirin group. (B) Although radial PSV was increased in both Aspirin and Triflusal groups by week 6, it was increased further only in Triflusal group by week 14 after cross-over while the Aspirin group showed no further change. Overall, although both Aspirin and Triflusal groups had increased radial PSV, the Triflusal group showed a more significantly increased PSV compared with Aspirin group. (C) ICG perfusion scan was significantly increased in the group that was treated with Triflusal compared with baseline or those treated with Aspirin. (D) ET-1 was significantly decreased in Triflusal group compared with Aspirin group by week 6, and this significant decreased was also observed after the cross-over. CISS, cold intolerance symptom severity; PSV, peak systolic velocity; ICG, indocyanine green.
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Figure 2: Primary, secondary, and exploratory endpoints. (A) Although the CISS scores of Aspirin and Triflusal groups both decreased by week 6, only the CISS score of Triflusal group decreased further by week 14 after cross-over, while that of Aspirin group remained unchanged. Overall, both Aspirin and Triflusal were effective in relieving symptoms, but Triflusal group had significantly more improved symptoms compared with Aspirin group. (B) Although radial PSV was increased in both Aspirin and Triflusal groups by week 6, it was increased further only in Triflusal group by week 14 after cross-over while the Aspirin group showed no further change. Overall, although both Aspirin and Triflusal groups had increased radial PSV, the Triflusal group showed a more significantly increased PSV compared with Aspirin group. (C) ICG perfusion scan was significantly increased in the group that was treated with Triflusal compared with baseline or those treated with Aspirin. (D) ET-1 was significantly decreased in Triflusal group compared with Aspirin group by week 6, and this significant decreased was also observed after the cross-over. CISS, cold intolerance symptom severity; PSV, peak systolic velocity; ICG, indocyanine green.

Mentions: The use of triflusal significantly reduced CISS by week 6 (64.4±12.0 vs. 47.4±16.1; p<0.001), and the reduction was also observed after crossover from aspirin to triflusal (55.9±12.0 vs. 41.5±20.2; p<0.001) (Table 3). The use of aspirin also improved CISS by week 6; however, no further improvement was seen after crossover from triflusal to aspirin. Overall, the use of triflusal resulted in a significantly greater improvement in symptoms compared to aspirin (44.5±18.4 vs. 51.9±16.2; p<0.001) (Fig. 2A).


Effect of Triflusal on Primary Vascular Dysregulation Compared with Aspirin: A Double-Blind, Randomized, Crossover Trial.

Shin S, Kim KJ, Cho IJ, Hong GR, Jang Y, Chung N, Rah YM, Chang HJ - Yonsei Med. J. (2015)

Primary, secondary, and exploratory endpoints. (A) Although the CISS scores of Aspirin and Triflusal groups both decreased by week 6, only the CISS score of Triflusal group decreased further by week 14 after cross-over, while that of Aspirin group remained unchanged. Overall, both Aspirin and Triflusal were effective in relieving symptoms, but Triflusal group had significantly more improved symptoms compared with Aspirin group. (B) Although radial PSV was increased in both Aspirin and Triflusal groups by week 6, it was increased further only in Triflusal group by week 14 after cross-over while the Aspirin group showed no further change. Overall, although both Aspirin and Triflusal groups had increased radial PSV, the Triflusal group showed a more significantly increased PSV compared with Aspirin group. (C) ICG perfusion scan was significantly increased in the group that was treated with Triflusal compared with baseline or those treated with Aspirin. (D) ET-1 was significantly decreased in Triflusal group compared with Aspirin group by week 6, and this significant decreased was also observed after the cross-over. CISS, cold intolerance symptom severity; PSV, peak systolic velocity; ICG, indocyanine green.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541651&req=5

Figure 2: Primary, secondary, and exploratory endpoints. (A) Although the CISS scores of Aspirin and Triflusal groups both decreased by week 6, only the CISS score of Triflusal group decreased further by week 14 after cross-over, while that of Aspirin group remained unchanged. Overall, both Aspirin and Triflusal were effective in relieving symptoms, but Triflusal group had significantly more improved symptoms compared with Aspirin group. (B) Although radial PSV was increased in both Aspirin and Triflusal groups by week 6, it was increased further only in Triflusal group by week 14 after cross-over while the Aspirin group showed no further change. Overall, although both Aspirin and Triflusal groups had increased radial PSV, the Triflusal group showed a more significantly increased PSV compared with Aspirin group. (C) ICG perfusion scan was significantly increased in the group that was treated with Triflusal compared with baseline or those treated with Aspirin. (D) ET-1 was significantly decreased in Triflusal group compared with Aspirin group by week 6, and this significant decreased was also observed after the cross-over. CISS, cold intolerance symptom severity; PSV, peak systolic velocity; ICG, indocyanine green.
Mentions: The use of triflusal significantly reduced CISS by week 6 (64.4±12.0 vs. 47.4±16.1; p<0.001), and the reduction was also observed after crossover from aspirin to triflusal (55.9±12.0 vs. 41.5±20.2; p<0.001) (Table 3). The use of aspirin also improved CISS by week 6; however, no further improvement was seen after crossover from triflusal to aspirin. Overall, the use of triflusal resulted in a significantly greater improvement in symptoms compared to aspirin (44.5±18.4 vs. 51.9±16.2; p<0.001) (Fig. 2A).

Bottom Line: We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin.The use of triflusal resulted in a greater improvement in CISS score (44.5±18.4 vs. 51.9±16.2; p<0.001) and in mean radial peak systolic velocity (69.8±17.2 vs. 66.1±16.4; p=0.011) compared to aspirin.Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

ABSTRACT

Purpose: Primary vascular dysregulation (PVD) is a condition in which the response to cold temperature or external stimuli is abnormal. We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin.

Materials and methods: Eighty-eight PVD patients (54% female, 56±8 years) were randomly selected to receive either triflusal (300 mg, b.i.d.) or aspirin (150 mg, b.i.d.) for a period of 6 weeks followed by crossover. PVD was defined as both red-blood-cell standstill in video-assisted microscopic capillaroscopy during cold stimulation using carbon dioxide gas and a score of more than 7 points in a validated questionnaire. Efficacy of treatment was assessed by 1) cold intolerance symptom severity (CISS) score, 2) finger Doppler indices, and 3) indocyanine green perfusion imaging.

Results: The use of triflusal resulted in a greater improvement in CISS score (44.5±18.4 vs. 51.9±16.2; p<0.001) and in mean radial peak systolic velocity (69.8±17.2 vs. 66.1±16.4; p=0.011) compared to aspirin. Furthermore, significant differences were also observed in perfusion rates on indocyanine green perfusion imaging between triflusal and aspirin (45.6±25.8 vs. 51.6±26.9; p=0.020).

Conclusion: Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.

Show MeSH
Related in: MedlinePlus