Document Detail


Is postoperative calcium channel blocker therapy needed in patients with radial artery grafts?
MedLine Citation:
PMID:  15746735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic calcium channel blocker therapy has traditionally been considered necessary in patients carrying a radial artery graft, even in the absence of objective data to support it. This report was conceived to evaluate the angiographic and clinical effects of calcium channel blocker therapy during the first postoperative year. PATIENTS AND RESULTS: A total of 100 consecutive patients who received a radial artery graft at our institution were randomly assigned to receive (n = 53) or not receive (n = 47) calcium channel blocker therapy with oral diltiazem 120 mg/daily started in the early postoperative period. At 1-year follow-up, all patients were reassessed clinically and by Tl 201 myocardial scintigraphy, and 83 of them underwent control angiography. In 12 cases we also evaluated the response of the radial artery to the endovascular infusion of serotonin. No difference in terms of clinical outcome, scintigraphic results, and patency rate was found between patients who received or did not receive calcium channel blocker therapy. Endovascular serotonin infusion evoked an evident spastic reaction of radial artery grafts, not attenuated by calcium channel blocker therapy. CONCLUSION: Calcium channel blocker therapy started immediately after surgery and continued for the first postoperative year does not affect radial artery graft patency and clinical and scintigraphic outcomes. On the basis of these data, the prophylactic use of calcium channel blocker therapy in patients with radial artery grafts seems unsubstantiated.
Authors:
Mario Gaudino; Nicola Luciani; Giuseppe Nasso; Andrea Salica; Carlo Canosa; Gianfederico Possati
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  129     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-04     Completed Date:  2005-04-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  532-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery, Catholic University, Rome, Italy. mgaudino@tiscali.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Calcium Channel Blockers / therapeutic use*
Coronary Angiography
Coronary Artery Bypass* / methods
Diltiazem / therapeutic use*
Female
Humans
Male
Postoperative Period
Radial Artery / transplantation*
Vascular Patency / drug effects*
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 42399-41-7/Diltiazem

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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