|Title||Antiischemic effects of nicardipine and nitroglycerin after coronary artery bypass grafting.|
|Publication Type||Journal Article|
|Year of Publication||1999|
|Authors||Apostolidou IA, Despotis GJ, Hogue CW, Skubas NJ, McCawley CA, Hauptmann EL, Lappas DG|
|Journal||Ann Thorac Surg|
|Date Published||1999 Feb|
|Keywords||Aged, Coronary Artery Bypass, Coronary Disease, Dose-Response Relationship, Drug, Electrocardiography, Ambulatory, Female, Hemodynamics, Humans, Infusions, Intravenous, Male, Middle Aged, Myocardial Ischemia, Nicardipine, Nitroglycerin, Postoperative Complications, Prospective Studies, Treatment Outcome, Vasodilator Agents|
BACKGROUND: We assessed the efficacy of a continuous infusion of nicardipine and nitroglycerin in reducing the incidence and severity of perioperative myocardial ischemia during elective coronary artery bypass grafting procedures in a prospective, randomized, controlled study.
METHODS: Patients received either nicardipine infusion (0.7 to 1.4 microg x kg(-1) x min(-1); n = 30) or nitroglycerin (0.5 to 1 microg x kg(-1) x min(-1); n = 30) or neither medication (n = 17) after aortic occlusion clamp release and for 24 hours postoperatively. Myocardial ischemic episodes (MIE) were considered to have occurred with ST-segment depressions or elevations of at least 1 mm and at least 2 mm (for both depressions or elevations), each at J + 60 ms and lasting at least 1 minute, using a two-channel Holter monitor.
RESULTS: Only nicardipine significantly decreased the duration (p = 0.02) of the 1-mm or greater minutes per hour (3.2 +/- 1.2 minutes per hour) and eliminated the number (p = 0.02) of the 2-mm or greater minutes per hour (zero minutes per hour) when compared with control patients (17.2 +/- 5.6 minutes per hour and 0.17 minutes per hour, respectively) during the intraoperative postbypass period.
CONCLUSIONS: Our results suggest that nicardipine lessened the severity of myocardial ischemia shortly after coronary revascularization and could be considered as an alternative to standard antiischemic therapy.
|Alternate Journal||Ann. Thorac. Surg.|