title: Effect of cutaneous nitroglycerin patches on coronary artery diameter: issues concerning development of tolerance.
abstract: The coronary dilative and systemic responses to graded doses of intracoronary nitroglycerin were studied in 53 patients undergoing diagnostic coronary arteriography, 43 of whom had received a cutaneous nitroglycerin patch. During coronary arteriography, graded doses of 50, 100 and 200 micrograms of intracoronary nitroglycerin were given 5 min apart. An arteriogram and hemodynamic measurements were obtained after each dose. In the control group (n = 10) cumulative intracoronary nitroglycerin doses of 50, 150 and 350 micrograms caused an increase in coronary diameter in the left anterior descending artery of 20 +/- 4%, 21 +/- 3% and 22 +/- 7%, respectively, and in the circumflex artery of 18 +/- 6%, 23 +/- 8% and 18 +/- 5% (p less than 0.01 versus values in untreated group). In Group 1 (15 patients given a 5 mg/24 h nitroglycerin patch 2 to 12 h before coronary arteriography), the same intracoronary nitroglycerin doses increased the left anterior descending artery diameter by 6 +/- 2%, 7 +/- 2% and 7 +/- 2%, respectively, and the circumflex artery diameter by 3 +/- 2%, 3 +/- 2% and 1 +/- 3%. All values were statistically different from control (p less than 0.05). An even more pronounced blunting (p less than 0.01) of the coronary dilative response was observed in Group 2 (14 patients given a 15 mg/24 h nitroglycerin patch 2 to 12 h before arteriography).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, 08903-0019.
authors.forename: A E
authors.initials: AE
authors.lastname: Moreyra
authors.forename: J B
authors.initials: JB
authors.lastname: Kostis
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000473:pathology*; D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000473:pathology*; D003331:Coronary Vessels / Q000187:drug effects* / Q000473:pathology; D004108:Dilatation, Pathologic / Q000139:chemically induced; D004361:Drug Tolerance; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*
chemical_list: D005996:Nitroglycerin