Ulfat Sultana, Momin Khan, Rizwan Faisal, Riffat Sultana, Aftab Khan.
Efficacy of nitrates and calcium channel blocker in prevention of radial artery spasm during coronary angiographies.
Pak J Med Res Jan ;57(3):110-5.
Background: Radial artery vasospasm is the most frequent complication of transradial cardiac catheterization. It causes discomfort and pain to the patient, prolongs the procedure and even makes it impossible for the interventionist to continue the procedure. Objective: To evaluate the efficacy of combined use of nitrate and calcium channel blocker (Verapamil) in prevention of radial artery spasm during coronary angiographies. Study design, settings and duration: It was a case control study conducted among 100 cardiac patients undergoing coronary angiography in Rehman Medical Institute (RMI) Peshawar from the duration of January 2016 to December 2016. Subjects and Methods: Sample selection was done through convenient non probability sampling technique. Written informed consent was taken from the patients included in the study. Patients were divided into two groups control (50) and experimental (50). One group was treated with heparin/nitrate as control group while other group was treated with heparin/nitrates/verapamil (Calcium channel blocker) as experimental group. Both groups were checked for radial spasm, pain and catheter resistance during angiography procedure. All other demography and history were collected through using a predesigned questionnaire. Data was collected, analyzed using SPSS version 16. Results: It was found that 63% patients were male, 37% were female and 68% cardiac patients were above the age 50 years. The study provided that using Verapamil as calcium channel blockers with nitrate does not put a significant effect on radial spasm with p value 0.806. The study provided that in comparison of cases and control for different variable, no significant difference was observed for radial spasm, pain, outcome, catheter resistance and time taken by the procedure. However the outcome of procedure was 100% successful among test group than control (98%). Conclusion: Calcium channel blocker (Verapamil) use with nitrate provided no significant difference in lowering radial spasm during coronary angiography. The assumption of using calcium channel blocker against radial artery spasm during angiography nullified. Policy message: Economic burden due to use of calcium channel blockers along with nitrate during coronary angiography should be avoided. There are no additional benefits of using calcium channel blocker (Verapamil) with nitrate. Key words: Calcium channel blocker, catheterization, angiography, radial spasm, nitrate, verapamil.
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