Key result
Intra-arterial nicorandil was as effective as a standard cocktail solution in preventing radial artery spasm during transradial coronary angiography (46% vs 58%, p=0.709).
Why the study?
Does nicorandil prevent radial artery spasm compared to a cocktail solution in patients undergoing transradial coronary angiography?
RCT (n=100)
Randomized
No
Does nicorandil prevent radial artery spasm compared to a cocktail solution in patients undergoing transradial coronary angiography?
Absolute Event Rate: 46% vs 58%
p-value: p=0.709
Intra-arterial nicorandil (4 mg) is as effective as a standard cocktail solution for preventing radial artery spasm during transradial coronary angiography.
Nicorandil offers a viable alternative to standard cocktail for radial spasm prevention; extends pharmacologic options in transradial procedures.
Background and Objectives:A radial artery spasm is one of the most common complications of coronary angiography during a transradial, causing considerable patient discomfort, which sometimes disturbs the procedure. This study was designed to evaluate the effects of nicorandil in the prevention of a radial artery spasm during coronary angiography. Subjects and Methods:This was a randomized study to compare 4 mg of nicorandil and a 10 mL cocktail solution performed in 100 patients. Vasospasms of the radial artery, which were expressed as stenosis of the vessel diameter with a transradial approach and radial artery patency by pulse oximetry analysis one month later, were examined. Results:Reductions in the systolic and diastolic blood pressures after administration of the spasmolytic agents were 15.8±11.8/ 8.4±8.0 and 20.5±13.6/6.7±6.2 in the for nicorandil and cocktail groups, respectively. Nicorandil induced a lesser decrease in the systolic BP than the cocktail, but without statistical significance (p=0.07). Both vasodilating agents showed a significant radial artery vasodilation following their intra-arterial administration (p<0.001 for all). The diameter of the radial artery showed a significant decrease in both groups following catheterization (p<0.05 for all). There were no significant differences between the two groups in terms of radial artery spasms (46 vs. 58% in nicorandil and cocktail groups, respectively, p=0.709). Conclusion:Nicorandil, with vasodilatory effects due to a dual mechanism was as effective as the cocktail solution in the vasodilation of the radial artery. (Korean Circulation J 2006;36:133-139)
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Kim et al. (2006) conducted an RCT in Transradial coronary angiography (n=100). Nicorandil vs. Cocktail solution (nitroglycerin 200 μg and verapamil 100 μg) was evaluated on Radial artery spasm (p=0.709). Intra-arterial nicorandil was as effective as a standard cocktail solution in preventing radial artery spasm during transradial coronary angiography (46% vs 58%, p=0.709).
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