ORIGINAL ARTICLES   

International Angiology 2001 December;20(4):337-44

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Clinical and hemorheological effects of buflomedil in diabetic subjects with intermittent claudication

Diamantopoulos E. J., Grigoriadou M., Ifanti G., Raptis S. A.

From the 4th Department of Internal Medicine and * 2nd Department of Internal Medicine-Propaedeutic of the Athens University Medical School, “Evangelismos” State General Hospital, Athens, Greece

Back­ground. Chang­es in blood rhe­ol­o­gy have been ­described in dia­betes mel­lit­us. Buflom­e­dil, a vasoac­tive sub­stance with hemo­rhe­o­log­i­cal prop­er­ties, has been wide­ly used in the treat­ment of inter­mit­tent claud­i­ca­tion. The aim of this study was to eval­u­ate the ­effect of buflom­e­dil on clin­i­cal and hemo­rhe­o­log­i­cal param­e­ters in sub­jects with type 2 dia­betes and inter­mit­tent claud­i­ca­tion.
Meth­ods. Forty ­patients were ran­dom­ly ­assigned to oral buflom­e­dil or match­ing pla­ce­bo for six ­months in a dou­ble-blind man­ner. ­Initial and abso­lute walk­ing dis­tanc­es were ­assessed by a stan­dard tread­mill test­ing pro­to­col. Eryth­ro­cyte deform­abil­ity was esti­mat­ed with a whole blood fil­tra­tion tech­nique. ADP- and col­la­gen-­induced plate­let aggre­ga­tion was ­assessed with an aggre­ga­tion pro­fil­er. β-throm­bo­glob­u­lin and plate­let fac­tor-4 were meas­ured with radio­im­mu­noas­says. All tests were per­formed at base­line and after three and six ­months of treat­ment.
­Results. A sig­nif­i­cant ­increase in the mean ­initial (71%) and abso­lute (68%) walk­ing dis­tance was ­achieved only in the buflom­e­dil group. ADP- and col­la­gen-­induced plate­let aggre­ga­tion was sig­nif­i­cant­ly ­reduced in the buflom­e­dil group, while no sig­nif­i­cant chang­es in eryth­ro­cyte deform­abil­ity, β-throm­bo­glob­u­lin and plate­let fac­tor-4 lev­els were ­noticed. How­ev­er, β-throm­bo­glob­u­lin lev­els ­increased sig­nif­i­cant­ly in the pla­ce­bo group.
Con­clu­sions. These find­ings sug­gest the ther­a­peu­tic effi­ca­cy of buflom­e­dil in dia­bet­ic sub­jects with inter­mit­tent claud­i­ca­tion. The inhi­bi­tion of plate­let aggre­ga­tion and the influ­ence on plate­let activ­ity exert­ed by the drug could play an impor­tant role in its clin­i­cal ­effect and may be of value in the treat­ment of such ­patients.