Department of Anesthesiology

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Antiischemic effects of nicardipine and nitroglycerin after coronary artery bypass grafting.

TitleAntiischemic effects of nicardipine and nitroglycerin after coronary artery bypass grafting.
Publication TypeJournal Article
Year of Publication1999
AuthorsApostolidou IA, Despotis GJ, Hogue CW, Skubas NJ, McCawley CA, Hauptmann EL, Lappas DG
JournalAnn Thorac Surg
Volume67
Issue2
Pagination417-22
Date Published1999 Feb
ISSN0003-4975
KeywordsAged, 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
Abstract

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 JournalAnn. Thorac. Surg.
PubMed ID10197663