title: Comparative study of the use of diltiazem as an antispasmodic drug in coronary angiography via the transradial approach.
abstract: OBJECTIVE
  To evaluate the impact of the use, prior to the procedure, of injectable diltiazem to prevent complications.
  
  
  METHODS
  Between September 2000 and July 2001, 50 patients underwent transradial coronary angiography and were randomized to receive placebo (GI) or diltiazem (GII) through a catheter inserted into the radial artery. All patients received isosorbide mononitrate. Ultrasound analyses of the radial artery were performed before examination, 30 minutes afterwards, and 7 days afterwards to evaluate the flow, the diameter, and the artery output.
  
  
  RESULTS
  The radial artery diameter of GI was 2.4d +/- 0.5 mm before the procedure and 2.3 +/- 0.5 mm after 30 minutes (NS), whereas in GII the diameter was 2.2 +/- 0.3 mm before the examination and +/- 2.5 0.4 mm 30 minutes after it (P<0.001). Radial artery output in group 1 was 7.3 +/- 5.l2 mL/min before the examination and 6.1 +/- 3.5 mL/min 30 minutes after the examination (NS), and GII had an increase of 5.9 +/- 2.5 mL/min before examination to 9.05 +/- 7.78 mL/min after the examination (P=0.04). Complications (spasm, occlusion, and partial obstruction) occurred in 4 patients (17.4%) in GI and did not occur in GII (P=0.04).
  
  
  CONCLUSIONS
  The study suggests a decrease in vascular complications through the transradial access for coronary angiography with the use of diltiazem as an antispasmodic drug, resulting in the significant increase in the diameter of the radial artery and radial artery output.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
authors.forename: José Ronaldo
authors.initials: JR
authors.lastname: Mont'Alverne Filho
authors.forename: João Alexandre Rezende
authors.initials: JA
authors.lastname: Assad
authors.forename: Alexandre do Canto
authors.initials: Ado C
authors.lastname: Zago
authors.forename: Ricardo Leite Vieira
authors.initials: RL
authors.lastname: da Costa
authors.forename: Antonio Guarany Mont'Alverne
authors.initials: AG
authors.lastname: Pierre
authors.forename: Mohamed Hassan
authors.initials: MH
authors.lastname: Saleh
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Barretto
authors.forename: Sérgio Luiz Navarro
authors.initials: SL
authors.lastname: Braga
authors.forename: Fausto
authors.initials: F
authors.lastname: Feres
authors.forename: Amanda Guerra Moraes Rego
authors.initials: AG
authors.lastname: Sousa
authors.forename: José Eduardo Moraes Rego
authors.initials: JE
authors.lastname: Sousa
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D004110:Diltiazem / Q000627:therapeutic use*; D004234:Diuretics, Osmotic / Q000494:pharmacology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007547:Isosorbide / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics / Q000627:therapeutic use*; D017534:Radial Artery / Q000033:anatomy & histology / Q000187:drug effects* / Q000502:physiology
chemical_list: D004234:Diuretics, Osmotic; D010276:Parasympatholytics; D004110:Diltiazem; D007547:Isosorbide