Intra-arterial nicardipine versus verapamil during transradial access coronary catheterization.
Cardiovasc Revasc Med
; 2024 Aug 20.
Article
en En
| MEDLINE
| ID: mdl-39191616
ABSTRACT
INTRODUCTION:
Intra-arterial (IA) vasodilators are recommended during transradial access (TRA) to prevent radial artery spasm (RAS). The American Heart Association (AHA) recommends either IA verapamil, diltiazem, nicardipine, or nitroglycerin to prevent RAS. To our knowledge, the efficacy of RAS prevention and patient tolerability of verapamil and nicardipine has not been directly compared in a randomized fashion.METHODS:
We conducted a prospective, single-blinded randomized clinical trial comparing the discomfort experienced by patients receiving either 400 µg of IA nicardipine (n = 26) or 5 mg of IA verapamil (n = 29). Patient discomfort and/or pain was assessed using the Visual Analogue Scale (VAS) both before and after IA administration of nicardipine or verapamil.RESULTS:
There was a statistically significant difference in mean change in VAS scores between the 2 groups, with an average increase in VAS score of 0.88 in the nicardipine group and 4.81 in the verapamil group (p < 0.0001). The overall rate of RAS was low in our study (5.5 %) with no significant difference in RAS incidence between the 2 groups (p = 0.465). The nicardipine group had 2 RAS cases (7.7 %), with 1 requiring a change in strategy (3.8 %). The verapamil group had 1 RAS case (3.4 %) that did not require a change in strategy.CONCLUSION:
In this trial, we showed that nicardipine causes significantly less discomfort and pain compared to verapamil during IA administration for TRA cardiac catheterization.
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Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Cardiovasc Revasc Med
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Estados Unidos