Korean Circ J.  2008 Apr;38(4):191-196. 10.4070/kcj.2008.38.4.191.

The Clinical Effects and Radial Artery Vasodilation After High Dose Nicorandil Solution During Coronary Angiography via the Radial Artery

• Cho YC
• Kim W
• Kim JT
• Jeong AD
• Cho SC
• Kang WY
• Whang SH
• Kim W

• KMID: 2225816
• DOI: http://doi.org/10.4070/kcj.2008.38.4.191

Abstract

BACKGROUND AND OBJECTIVES: A spasm of the radial artery is one of the most common complications of coronary angiography (CAG) via the transradial approach (TR), and this spasm sometimes disturbs the procedure. Nicorandil has recently shown dose-dependent dilatation of the blood vessels and ischemic preconditioning. This study was designed to evaluate the clinical effects and radial artery vasodilation of high dose nicorandil solution during CAG via the radial artery.
SUBJECTS AND METHODS
This study was a prospective, randomized study to compare the effects of 12 mg of nicorandil (the Nicorandil group) and 10 mL of a cocktail solution (nitroglycerine 200 microgram mixed with verapamil 100 microgram) (the Cocktail group) in 146 patients. Vasospasms, which were expressed as the stenosis of the radial artery were examined at 2 parts of the radial artery.
RESULTS
There were no significant difference of gender, age and risk factors for the 2 groups of patients. The reductions in the systolic and diastolic blood pressure (BP) 1 minute after drug administration were 33.6+/-11.4/10.4+/-7.7 mmHg in the Nicorandil group and 12.8+/-9.8/3.8+/-5.3 mmHg in the Cocktail group (p<0.001). Both vasodilating agents showed significant radial artery vasodilation after administration of the drugs (p<0.005 for all). The minimal luminal diameter (MLD) after drug administration was more dilated in the Nicorandil group than that in the Cocktail group (0.63+/-0.25 mm vs. 0.48+/-0.19 mm, respectively, p=0.013).
CONCLUSION
Nicorandil solution was more effective for inducing vasodilation of the radial artery, but it was not clinical superior to the cocktail solution.

Keyword

Vasodilator agents; Radial artery

MeSH Terms

Blood Pressure
Blood Vessels
Constriction, Pathologic
Coronary Angiography
Dilatation
Humans
Ischemic Preconditioning
Nicorandil
Phenobarbital
Prospective Studies
Radial Artery
Risk Factors
Spasm
Vasodilation
Vasodilator Agents
Verapamil
Nicorandil
Phenobarbital
Vasodilator Agents
Verapamil

Figure

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  Fig. 1 Angiographic analysis of radial artery diameter. At baseline, after vasodilator administration and after procedure.

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  Fig. 2 Mean changes of systolic and diastolic blood pressure from baseline after nicorandil and cocktail administration. SBP: systolic blood pressure, DBP: diastolic blood pressure.

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  Fig. 3 Change of radial artery diameter at proximal segment. For both groups, radial artery mean diameter shows a significant increase after vasodilator administration and a marked decrease after procedure.

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  Fig. 4 Change of minimal luminal diameter of radial artery after vasodilator administration.

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