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Ann Thorac Surg. 1999 Feb;67(2):417-22.

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

Author information

1
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. apostoli@notes.wustl.edu

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.

PMID:
10197663
DOI:
10.1016/s0003-4975(98)01039-x
[Indexed for MEDLINE]

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