Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-carterial nitroglycerin in transradial procedures: A randomized trial
Cardiovascular Revascularization Medicine, cilt.16, sa.7, ss.391-396, 2015 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 16 Sayı: 7
- Basım Tarihi: 2015
- Doi Numarası: 10.1016/j.carrev.2015.07.006
- Dergi Adı: Cardiovascular Revascularization Medicine
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.391-396
- Anahtar Kelimeler: Radial artery, Angiography, Nitroglycerin
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: Sublingual (SL) nitroglycerin administered before radial artery puncture can improve cannulation success and decrease the incidence of radial artery spasm (RAS) compared with intra-arterial (IA) nitroglycerin in transradial procedures. Methods: Patients undergoing diagnostic transradial angiography were randomized to IA (200 mcg) or SL (400 mcg) nitroglycerin. Primary endpoints were puncture time and puncture attempts. Secondary endpoint was the incidence of RAS. Results: Total of 101 participants (mean age 60 ± 11 years, 53% male) were randomized (51 in IA and 50 in SL groups). Puncture time (50 [36-75] vs 50 [35-90] sec), puncture attempts (1.18 ± 0.48 vs 1.20. ± 0.49), multiple punctures (13.7 vs 16.0%) and RAS (19.6 vs 24.0%) were not statistically different between IA vs SL groups respectively. A composite endpoint of all adverse events related to transradial angiography (multiple punctures, RAS, access site crossover, hypotension/bradycardia associated with nitroglycerin and radial artery occlusion) was very similar in IA vs SL groups (39 vs 40%, respectively). However puncture time was significantly longer with SL nitroglycerin in patients <. 1.65. m height (47 [36-66] vs 63 [41-110] sec, p = 0.042). Multiple punctures seemed higher with SL nitroglycerin in patients with diabetes (0 vs 30%, p = 0.028) or in patients < 1.65. m height (7.4 vs 25%, p = 0.085). Likewise, RAS with SL nitroglycerin seemed more frequent in smokers compared to IA nitroglycerin (0 vs 27%, p = 0.089). Conclusions: SL nitroglycerin was not different from IA nitroglycerin in terms of efficiency and safety in overall study population. However it may be inferior to IA nitroglycerin in certain subgroups (shorter individuals, diabetics and smokers).