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December 1, 1993Asian Cardiovascular and Thoracic Annals

Perioperative Myocardial Protection with Continuous Infusion of Diltiazem in Coronary Bypass Surgery

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Why the study?

Does continuous perioperative infusion of diltiazem improve antiischemic and antiarrhythmic outcomes compared to nitroglycerin in patients undergoing elective coronary artery bypass grafting?

Population

120 patients undergoing elective coronary artery bypass grafting (CABG)

Comparison

Continuous perioperative infusion of diltiazem… vs Continuous perioperative infusion of…

Design

RCT, Randomized

Follow-up

Up to 24 hours postoperatively

Authors

RSRainald SeitelbergerUniversity of SalzburgWHWaltraud HannesUniversity of Freiburg

Discussion

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Implication

Supports diltiazem over nitroglycerin for perioperative ischemia and AF reduction in CABG; extends RCT evidence for calcium-channel blockers in cardiac surgery.

Structured PICO

Does continuous perioperative infusion of diltiazem improve antiischemic and antiarrhythmic outcomes compared to nitroglycerin in patients undergoing elective coronary artery bypass grafting?

P
Population
120 patients undergoing elective coronary artery bypass grafting (CABG)
I
Intervention
Continuous perioperative infusion of diltiazem 0.1 mg/kg/h over a period of 24 hours
C
Comparator
Continuous perioperative infusion of nitroglycerin (lpg/kg/min) over a period of 24 hours
O
Outcome
Perioperative antiischemic and antiarrhythmic efficacy (including transient ischemic events, perioperative myocardial infarction, CK-MB, troponin-T, atrial fibrillation, and ventricular premature beats)

Continuous perioperative infusion of diltiazem provides potent antiischemic and antiarrhythmic protection without adversely affecting hemodynamics in patients undergoing elective CABG.

Cite This Study

Seitelberger et al. (1993) studied this question.

synapsesocial.com/papers/6a7ccfeee130ea38cea4629chttps://doi.org/10.1177/021849239300100407
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Short- and long-term efficacy of high-dose oral diltiazem for angina due to coronary artery disease: a placebo-controlled, randomized, double-blind crossover study.1983 · 99 citations
  2. 2Effects of a calcium-entry blocker (diltiazem) on regional myocardial flow and function during exercise in conscious dogs.1984 · 87 citations
  3. 3Distribution of myocardial blood flow in the exercising dog with restricted coronary artery inflow.1976 · 111 citations
  4. 4Diltiazem provides anti-ischemic and anti-arrhythmic protection in patients undergoing coronary bypass grafting1993 · 38 citations
  5. 5Effects of ischaemia and reperfusion on calcium exchange and mechanical function in isolated rabbit myocardium1981 · 138 citations