Comparative study of nicorandil and a spasmolytic cocktail in preventing radial artery spasm during transradial coronary angiography

• Published in: International journal of cardiology Vol. 120; no. 3; pp. 325 - 330
• Main Authors: Kim, Seong Hwan, Kim, Eung Ju, Cheon, Won Seok, Kim, Min-Kyu, Park, Woo Jung, Cho, Goo-Yeong, Choi, Young Jin, Rhim, Chong Yun
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 03.09.2007; Elsevier Science
• Subjects: Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Coronary angiography; Coronary Angiography - adverse effects; Coronary Angiography - methods; Coronary Artery Disease - diagnosis; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Double-Blind Method; Female; Heart; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Nicorandil; Nicorandil - therapeutic use; Prospective Studies; Radial artery; Radial Artery - diagnostic imaging; Radial Artery - drug effects; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Spasm; Spasm - prevention & control; Vasodilator Agents - therapeutic use; Verapamil - therapeutic use; Coronary angiography; Spasm; Nicorandil; Radial artery; Radiodiagnosis; Angiography; Cardiovascular disease; Coronary arteriography; Coronary heart disease; Phlebology; Arterial disease; Vascular disease; Prevention; Coronary Artery Spasm; Circulatory system; Cardiology; Comparative study
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2006.10.008

Abstract Background Radial artery spasm is one of the most common complications during coronary angiography via the transradial approach, causing patient discomfort or sometimes interrupting the procedure. This study was designed to compare the spasmolytic effect between nicorandil and a cocktail during transradial coronary angiography. Methods A randomized study to compare 4 mg of nicorandil and a coctail (mixture of normal saline, 200 μg of verapamil) was performed in 150 patients. We examined vasospasms of the radial artery that were expressed as stenosis of the radial artery vessel diameter after the procedure. Result The reductions of systolic and diastolic blood pressures showed no significant differences between the two groups (15.4 ± 11.5/7.7 ± 7.8 mmHg for nicorandil and 16.3 ± 13.4/6.2 mmHg for cocktail). Both agents induced a significant radial artery vasodilation after transradial administration at proximal and mid segments ( P < 0.001 for all). Nicorandil showed a significant increase of the mean change of the radial artery diameter compared to the cocktail at mid-segment (0.32 ± 0.23 mm for nicorandil and 0.24 ± 0.15 mm for a cocktail, P < 0.05). There was no statistically significant difference between the two groups in radial artery spasm (50.7% vs. 52.0% in nicorandil and a cocktail, respectively) after catheterization. Conclusion Nicorandil with vasodilator effects by a dual mechnism was effective as the cocktail in preventing radial artery spasm during transradial coronary angiography.