Key result
In patients with single-vessel CAD, 24% had spontaneously visible and 30% had recruitable collaterals; intravenous nitroglycerin neither recruited nor augmented these collaterals.
Why the study?
Does intravenous nitroglycerin augment or recruit coronary collaterals in patients with single-vessel CAD undergoing PTCA?
Observational (n=101)
Does intravenous nitroglycerin augment or recruit coronary collaterals in patients with single-vessel CAD undergoing PTCA?
Intravenous nitroglycerin does not recruit or augment coronary collaterals during PTCA in patients with single-vessel CAD.
Answers are grounded in this paper and cite their sources.
IV nitroglycerin should not target collateral recruitment in single-vessel CAD during PTCA; leaves open effects in multivessel disease or randomized settings.
BACKGROUND: Although the protective role of collaterals in coronary artery disease (CAD) is well known, the influence of drugs on collateral function remains controversial. HYPOTHESIS: We aimed to investigate prospectively the prevalence of spontaneously visible and recruitable coronary collaterals in consecutive patients with single-vessel CAD and the effect of systemic administration of nitroglycerin on these types of collaterals during percutaneous transluminal coronary angioplasty (PTCA). METHODS: Ipsi- and contralateral coronary artery contrast injections were performed before and during PTCA. Simultaneously with balloon occlusion, we measured coronary artery occlusion pressure via the balloon catheter. All measurements were repeated after administration of 0.5 mg of nitroglycerin intravenously. RESULTS: Of 101 consecutive patients, 24% had spontaneously visible and 30% had recruitable collaterals. Contralateral collaterals were five times more frequent than ipsilateral collaterals. Presence of collaterals was highly associated with the degree of coronary stenosis. Coronary occlusion pressure was higher in patients with than in those without collaterals. Collaterals prevented pain and ischemia during PTCA, and in this respect spontaneously visible collaterals were more effective than recruitable collaterals. There was no effect of systemic administration of nitroglycerin on appearance or occlusion pressure of coronary collaterals. CONCLUSION: Coronary collaterals were found in more than half of patients with single-vessel CAD, as the prevalence of recruitable collaterals was slightly higher than that of spontaneously visible collaterals. Nitroglycerin did neither recruit nor augment coronary collaterals.
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Eriksen et al. (2002) conducted an observational in Single-vessel coronary artery disease (n=101). Nitroglycerin vs. Baseline (before administration) was evaluated on Appearance or occlusion pressure of coronary collaterals. In patients with single-vessel CAD, 24% had spontaneously visible and 30% had recruitable collaterals; intravenous nitroglycerin neither recruited nor augmented these collaterals.
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