Clinical study of the preventive role of oral nicorandil on artery spasm in transradial radial interventing treatment
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摘要: 目的:观察术前应用尼可地尔口服制剂在经桡动脉途径介入诊疗中预防桡动脉痉挛 (radial artery spasm, RAS) 的疗效及安全性。方法:选择经桡动脉途径介入检查和治疗的患者400例, 随机分成尼可地尔组 (术前给予尼可地尔片5mg口服) 和对照组, 比较两组RAS发生率, 并观察尼可地尔的不良反应。结果:实际入选病例分为尼可地尔组198例, 对照组199例。完成单纯冠状动脉 (冠脉) 造影 (CAG) 和冠脉介入治疗 (CAG+PCI) 的例数, 两组无统计学差异。行单纯CAG, 尼可地尔组RAS发生率低于对照组 (9.7%:20.8%, P<0.05);行CAG+PCI, 尼可地尔组与对照组RAS发生率差异无统计学意义 (17.2%:23.2%, P>0.05);但总和RAS发生率, 尼可地尔组与对照组比较, 差异有统计学意义 (12.1%:21.6%, P<0.05)。尼可地尔组不良反应发生率低且轻微。结论:经桡动脉途径冠脉介入诊疗术前口服尼可地尔能安全、有效地预防单纯CAG桡动脉痉挛的发生, 但不能有效预防CAG+PCI桡动脉痉挛。Abstract: Objective: To observe the effectiveness and the security of oral nicorandil before intervention treatment on the preventing of radial artery spasm.Method: All 400 patients (transradial approach involves examination and treatment) were randomly divided into nicorandil group (preoperative nicorandil tablets, 5mg p.o) and control group.RAS records, the incidence and outlook, and adverse reactions were compared.Result: The patients were actually enrolled into nicorandil group with 198 cases, 199 cases in control group.There were no angiography alone (CAG) and percutaneous coronary intervention (CAG + PCI) between two groups.With simple CAG, the RAS incidence was lower in nicorandil group than that in control group (9.7% vs 20.8%, P<0.05);With CAG+ PCI, there was no statistically significant difference between two groups (17.2% vs 23.2%, P>0.05);There was statistically significant in total incidence of RAS between nicorandil group and control group (12.1% vs 21.6%, P<0.05).The adverse reactions in nicorandil group was low and mild.Conclusion: The oral nicorandil treatment before transradial coronary intervention is safe, simple and effective in preventing the occurrence of CAG radial artery spasm but not effective in preventing CAG + PCI radial artery spasm.
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Key words:
- radial artery spasm /
- interventional treatment /
- nicorandil /
- oral /
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[1] CHEN C W, LIN C L, LIN T K, et al.A simple and effective regimen for prevention of radial artery spasm during coronary catheterization[J].Cardiology, 2006, 105:43-47.
[2] KIM S H, KIM E J, CHEON W S, et al.Comparative study of nicorandil and a spasmolytic cocktail in preventing radial artery spasm during transradial coronary angiography[J].Int J Cardiol, 2007, 120:325-330.
[3] CARRILLO X, MAURI J, FERNANDEZ-NOFRERIAS E, et al.Safety and efficacy of transradial access in coronary angiography:8-year experience[J].J Invasive Cardiol, 2012, 24:346-351.
[4] 钟继明, 李浪, 陆永光, 等.经桡动脉冠心病介入诊疗中桡动脉痉挛的发生及其预测因素[J].介入放射学杂志, 2011, 20 (4):265-268.
[5] ERCAN S, UNAL A, ALTUNBAS G, et al.Anxiety score as a risk factor for radial artery vasospasm during radial interventions:apilot study[J].Angiology, 2014, 65:67-70.
[6] TUNCEZ A, KAYA Z, ARAS D, et al.Incidence and predictors of radial artery occlusion associated transradial catheterization[J].Int J Med Sci, 2013, 10:1715-1719.
[7] BOYER N, BEYER A, GUPTA V, et al.The effects of intra-arterial vasodilators on radial artery size and spasm:implications for contemporary use of trans-radial access for coronary angiography and percutaneous coronary intervention[J].Cardiovasc Revasc Med, 2013, 14:321-324.
[8] CARRILLO X, FERNANDEZ-NOFRERIAS E, CIOMPI F, et al.Changes in radial artery volume assessed using intravascular ultrasound:a comparison of two vasodilator regimens in transradial coronary interventions[J].J Invasive Cardiol, 2011, 23:401-404.
[9] DHARMA S, SHAH S, RADADIYA R, et al.Nitroglycerin plus diltiazem versus nitroglycerin alone for spasm prophylaxis with transradial approach[J].J Invasive Cardiol, 2012, 24:122-125.
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