Abstract |
To evaluate the effect of intracoronary diltiazem on myocardial ischemia during percutaneous transluminal coronary angioplasty (PTCA), 38 patients were randomly assigned to receive inactive placebo (n = 19; group C) or a low dose (1 mg, n = 10; group D1), or a high dose (2 or 3 mg, n = 9; group D2) of diltiazem in a double-blind manner. The agent was administered directly into the coronary artery via a balloon catheter following a control balloon inflation. Chest pain score (maximum, 10) and the magnitude of ischemic ST elevation on standard and intracoronary electrocardiograms (ECGs) during a balloon inflation were assessed in the control and posttreatment periods. After the administration of diltiazem, the chest pain score was significantly decreased in group D1 (control: 5.1 +/- 3.6, posttreatment: 3.8 +/- 3.1, P < 0.01) and group D2 (3.4 +/- 2.5 vs 2.5 +/- 2.0, P < 0.01), but not in group C (4.1 +/- 3.1 vs 3.7 +/- 3.3, difference not significant). The magnitude of ST elevation relative to the control on standard and intracoronary ECGs was significantly smaller in groups D1 and D2 than in group C (standard ECG; D1: 51.8 +/- 10.6% of control, D2: 41.6 +/- 28.7% vs C: 93.3 +/- 15.6% and intracoronary ECG; D1: 47.1 +/- 11.7% of control, D2: 27.5 +/- 26.9% vs C: 94.6 +/- 29.3%, all P < 0.01). Although systolic blood pressure decreased slightly in groups D1 and D2, there was no significant correlation between the change in ST elevation and the change in the rate-pressure product. Pretreatment with a small dose of intracoronary diltiazem attenuated myocardial ischemia during PTCA and this pretreatment may enable us to perform balloon inflation for a longer period.
|
Authors | K Saito, H Nonogi, Y Goto, A Itoh, S Daikoku, S Miyazaki, K Haze |
Journal | Heart and vessels
(Heart Vessels)
Vol. 11
Issue 2
Pg. 92-9
( 1996)
ISSN: 0910-8327 [Print] Japan |
PMID | 8836757
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Calcium Channel Blockers
- Diltiazem
|
Topics |
- Angina Pectoris
(therapy)
- Angioplasty, Balloon, Coronary
- Calcium Channel Blockers
(administration & dosage, therapeutic use)
- Coronary Disease
(therapy)
- Coronary Vessels
- Diltiazem
(administration & dosage, therapeutic use)
- Double-Blind Method
- Electrocardiography
- Female
- Humans
- Injections, Intra-Arterial
- Male
- Middle Aged
- Myocardial Reperfusion Injury
(etiology, prevention & control)
- Time Factors
|