Effectiveness of a novel serotonin blocker, sarpogrelate, for patients with angina pectoris

Background We have recently demonstrated that a single oral administration of sarpogrelate, a 5-HT2A receptor antagonist, may improve exercise capacity in anginal patients with well-developed collaterals. The aim of the current study was to investigate the effectiveness of 2-week treatment with sarpogrelate on anginal symptoms and exercise capacity in anginal patients. Methods A treadmill exercise test was repeated after a 2-week period with or without sarpogrelate (100 mg 3 times a day) in 20 patients with angiographically proven stable angina. Anginal symptoms and daily physical activity by the specific activity scale (SAS) were also evaluated. Results Treatment with sarpogrelate significantly increased the SAS score and prolonged exercise time to the onset of 0.1-mV ST depression. When data were analyzed in a subgroup of patients (n = 8) with well-developed collaterals, the treatment with sarpogrelate decreased the number of anginal attacks (control vs sarpogrelate, 3.0 ± 2.8 vs 0.9 ± 1.1/2 weeks, P < .05), increased the SAS score (5.2 ± 1.6 vs 6.2 ± 1.3 METS, P < .05), and increased the time to the onset of 0.1-mV ST depression (235 ± 84 vs 295 ± 127 seconds, P < .05). In addition, the double product at the onset of 0.1-mV ST depression increased by 15% (P < .05) after sarpogrelate. In contrast, all parameters were not significantly changed after sarpogrelate treatment in patients (n = 12) without well-developed collaterals. Conclusions These findings indicate the therapeutic effectiveness of sarpogrelate for anginal patients, especially for patients with well-developed collaterals. (Am Heart J 2002;144:e1.)