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Effect of Intracoronary Nicorandil Compared To Nitroglycerin on Coronary Diameter and Hemodynamics Following Balloon Dilatation during Elective PTCA

Thulaseedharan Sarojadevi Ashida , Thulaseedharan Sarojadevi Ashida , Rangasamy Balamurugan ,

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Journal of Cardiovascular Medicine and Surgery 5(2):p 57-60, Apr-June 2019. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.5219.2

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Thulaseedharan Sarojadevi Ashida, Rangasamy Balamurugan. Effect of Intracoronary Nicorandil Compared To Nitroglycerin on Coronary Diameter and Hemodynamics Following Balloon Dilatation during Elective PTCA. J Cardiovasc Med Surg. 2019;5(2):57-60.
 

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Abstract

Introduction: Vasodilators are important drugs to relieve coronary spasm during coronary interventions. Use of Intracoronary (IC) Nitroglycerin (NTG) during PTCA helps to prevent or treat coronary vasospasm, augment coronary collateral flow and also helps in appropriate sizing of stents. Hemodynamic effects of NTG may preclude its use in some patients. Nicorandil (NIC) is used as a coronary vasodilator and has a favourable hemodynamic profile. Materials and Methods: 34 patients planned for elective PTCA with coronary stenosis more than 70% were included in the study. Alternate patients received intracoronary administration of 200 microgram of Nitroglycerin (NTG) or 1 mg Nicorandil (NIC). Hemodynamic parameters, TIMI flow grade and coronary diameters were analysedin both groups. Results: I.C administration of NTG resulted in significant increase in heart rate (72 ± 10.6 vs 101 ± 9.5 p<0.0001) and a reduction in Mean aortic pressure (80 ± 9.5 vs 69 ± 9.5 p<0.0001). I.C Nicorandil did not produce any significant variation in Heart rate or mean aortic pressures. Both groups showed significant increase in coronary diameters following I.C administration of NTG and Nicorandil (2.02 ± 0.12 and 2.16 ± 0.18 mm respectively). Intracoronary Nicorandil produced a greater coronary vasodilatation than NTG but the values were statistically nonsignificant (2.16 ± 0.18 mm vs 1.83 ± 0.17 mm p=0.05). Conclusion: Intracoronary Nicorandil produces a significant increase in coronary diameter following balloon dilatation without adverse effects on hemodynamic parameters compared to nitroglycerine. Nicorandil use was associated with higher TIMI 3 grades. Routine use of Nicorandil may be beneficial as a vasodilatory and cardioprotective agent during PTCA.

 

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Thulaseedharan Sarojadevi Ashida, Rangasamy Balamurugan. Effect of Intracoronary Nicorandil Compared To Nitroglycerin on Coronary Diameter and Hemodynamics Following Balloon Dilatation during Elective PTCA. J Cardiovasc Med Surg. 2019;5(2):57-60.
 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.5219.2

Keywords

Coronary diameter; Hemodynamics; Nicorandil; Nitroglycerine; PTCA; TIMI flow grade.

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