Comparative study of nicorandil and a spasmolytic cocktail in preventing radial artery spasm during transradial coronary angiography.
BACKGROUND
Radial artery spasm is one of the most common complications during coronary angiography via the transradial approach, causing patient discomfort or sometimes interrupting the procedure. This study was designed to compare the spasmolytic effect between nicorandil and a cocktail during transradial coronary angiography.


METHODS
A randomized study to compare 4 mg of nicorandil and a cocktail (mixture of normal saline, 200 microg of verapamil) was performed in 150 patients. We examined vasospasms of the radial artery that were expressed as stenosis of the radial artery vessel diameter after the procedure.


RESULTS
The reductions of systolic and diastolic blood pressures showed no significant differences between the two groups (15.4+/-11.5/7.7+/-7.8 mmHg for nicorandil and 16.3+/-13.4/6.2 mmHg for cocktail). Both agents induced a significant radial artery vasodilation after transradial administration at proximal and mid segments (P < 0.001 for all). Nicorandil showed a significant increase of the mean change of the radial artery diameter compared to the cocktail at mid-segment (0.32+/-0.23 mm for nicorandil and 0.24+/-0.15 mm for a cocktail, P < 0.05). There was no statistically significant difference between the two groups in radial artery spasm (50.7% vs. 52.0% in nicorandil and a cocktail, respectively) after catheterization.


CONCLUSIONS
Nicorandil with vasodilator effects by a dual mechanism was effective as the cocktail in preventing radial artery spasm during transradial coronary angiography.
Kim
Seong Hwan
SH
Division of Cardiology, Department of Internal Medicine, Hallym University Medical Center, 94-200, Yeongdeungpo-dong, Yeongdeungpo-gu, 150-030, Seoul, Republic of Korea. cardioguy@korea.ac.kr
Kim
Eung Ju
EJ
Cheon
Won Seok
WS
Kim
Min-Kyu
MK
Park
Woo Jung
WJ
Cho
Goo-Yeong
GY
Choi
Young Jin
YJ
Rhim
Chong Yun
CY
D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000627:therapeutic use*; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging* / Q000187:drug effects; D013035:Spasm / Q000517:prevention & control*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014700:Verapamil / Q000627:therapeutic use*
D014665:Vasodilator Agents; D020108:Nicorandil; D014700:Verapamil