Document Detail


Effect of pre-treatment with transdermal glyceryl trinitrate on myocardial ischaemia during coronary angioplasty.
MedLine Citation:
PMID:  9014793     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In the light of the reported inconsistent anti-ischaemic and antianginal effects of transdermal glyceryl trinitrate, its efficacy and influence on the effects of intracoronary glyceryl trinitrate were examined during coronary angioplasty, which provides a model of controlled, reversible ischaemia. DESIGN: Double blind, randomised study of the effect of transdermal and intracoronary glyceryl trinitrate on ischaemia during coronary angioplasty. PATIENTS: 40 patients with isolated severe stenosis of the left anterior descending coronary artery. INTERVENTIONS: Patients were randomised (double blind) to transdermal glyceryl trinitrate (10 mg per day) and placebo, starting four to six hours before angioplasty. After 4 one-minute balloon inflations intracoronary glyceryl trinitrate was injected (0.2 mg) and then 4 further one-minute inflations were performed. MAIN OUTCOME MEASURES: The time to angina and the time to > 0.2 mV ST shift on surface electrocardiogram (ECG) or intracoronary ECG during the individual inflations. RESULTS: These times did not significantly differ during initial inflations between transdermal glyceryl trinitrate (27 (11), 25 (9), and 19 (9) s, respectively) and placebo (34 (11), 30 (8), and 21 (7) s. After intracoronary glyceryl trinitrate, they were significantly prolonged compared with the initial values, without differences between patients with transdermal glyceryl trinitrate (37 (10), 30 (8), and 23 (8) s, respectively) or placebo (39 (15), 36 (11), and 28 (12) s). Ischaemic preconditioning was not seen. CONCLUSIONS: Transdermal glyceryl trinitrate (10 mg per day), unlike intracoronary glyceryl trinitrate, did not alleviate the myocardial ischaemia produced by balloon inflation during coronary angioplasty.
Authors:
S Ramamurthy; V Mehan; U Kaufmann; V Verin; T F Lüscher; B Meier
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  76     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-02-18     Completed Date:  1997-02-18     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  471-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University Hospital, Bern, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Disease / physiopathology,  surgery*
Coronary Vessels
Double-Blind Method
Electrocardiography
Female
Humans
Injections, Intra-Arterial
Intraoperative Complications / prevention & control*
Male
Middle Aged
Myocardial Ischemia / physiopathology,  prevention & control*
Nitroglycerin / administration & dosage*,  therapeutic use
Premedication*
Chemical
Reg. No./Substance:
55-63-0/Nitroglycerin
Comments/Corrections

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