Perioperative sublingual isosorbide dinitrate for the prevention of cardiac complications in cardiac patients undergoing noncardiac surgery.
One hundred fifty-two consecutive patients with a known or suspected diagnosis of atherosclerotic coronary artery disease were administered 5 mg sublingual isosorbide dinitrate 2 hours and (1/2) hour preoperatively and every 4 hours postoperatively for 3 days, for the prevention of cardiovascular morbidity and mortality, which could result from various noncardiac surgical procedures; 125 patients received general anesthesia. Cardiovascular complications occurred in 3 patients (1.9%). Two patients did not enter the study, owing to side effects of the medication (1.3%). The complications were 1 each (0.6%) of the following: atrial fibrillation, hypotension, and cardiac arrest. Mortality was 0%. These results are exceptionally favorable when compared to the average cardiovascular morbidity rate of 2.8% to 49% in patients assigned to various risk stratifications in the medical literature.
RuDusky
Basil M
BM
Northeast Cardiac Clinic and Research Institute, Wilkes-Barre, PA 18701, USA.
D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006331:Heart Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate