Clevidipine was associated with significantly fewer systolic blood pressure excursions outside the target range compared to nitroglycerin during carotid endarterectomy (median AUC 29.59 vs 60.30 mmHg × min, p=0.005).
Cohort (n=40)
No
Does clevidipine improve intraoperative blood pressure control compared to nitroglycerin in patients undergoing carotid endarterectomy?
Clevidipine provides superior intraoperative systolic blood pressure control with fewer excursions outside the target range compared to nitroglycerin during carotid endarterectomy.
Absolute Event Rate: 29.59% vs 60.3%
p-value: p=0.005
BACKGROUND: Clevidipine is an ultrafast-acting dihydropyridine calcium channel antagonist with selective arteriolar-dilating effects that may be suitable for afterload reduction during surgeries requiring tight blood pressure control. The objective of this single-center retrospective observational study was to evaluate the role of clevidipine to control blood pressure during carotid endarterectomy. METHODS: Patients undergoing elective carotid endarterectomy from October 2024 to March 2025 who received clevidipine or nitroglycerin for intraoperative blood pressure management were included. The primary endpoint was the area under the curve of systolic blood pressure excursions outside the predefined target range of 140-160 mmHg. Secondary outcomes included corresponding measurements for mean arterial pressure and heart rate, as well as the incidence of significant clinical complications. RESULTS: Of 40 included patients, 20 received clevidipine and 20 received nitroglycerin. Patients in the clevidipine group spent significantly less time outside the goal systolic blood pressure range than the nitroglycerin group (10 min vs. 37.5 min, p < 0.001). The median normalized area under the curve per five-minute intervals was 29.59 mmHg × min (interquartile range, 15.83 to 49.35) in the clevidipine group versus 60.30 mmHg × min (interquartile range 42.79 to 74.38) in the nitroglycerin group (p = 0.005). There were no significant differences in mean arterial pressure, heart rate, or clinical complications between the groups. CONCLUSIONS: Clevidipine was associated with significantly fewer blood pressure excursions outside the target goal range compared to nitroglycerin during carotid endarterectomy.
Labanca et al. (Mon,) conducted a cohort in Carotid stenosis requiring carotid endarterectomy (n=40). Clevidipine vs. Nitroglycerin was evaluated on Area under the curve (AUC) of systolic blood pressure excursions outside the predefined target range of 140-160 mmHg, normalized per five-minute intervals (p=0.005). Clevidipine was associated with significantly fewer systolic blood pressure excursions outside the target range compared to nitroglycerin during carotid endarterectomy (median AUC 29.59 vs 60.30 mmHg × min, p=0.005).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: