Liu Sha, Qiu Yuangang, Lv Chuqun
Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, Zhejiang Province, China.
The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Shangcheng District, Hangzhou City, Zhejiang Province, China.
Am Heart J Plus. 2024 Sep 7;46:100461. doi: 10.1016/j.ahjo.2024.100461. eCollection 2024 Oct.
Nicorandil and verapamil can improve coronary blood flow and coronary microcirculation during percutaneous coronary intervention. However, the effects of intracoronary (IC) administration of nicorandil and verapamil on hemodynamics remain unclear.
To clarify the safety and effects of IC administration of nicorandil and verapamil on blood pressure (BP) and heart rate (HR) to provide evidence-based basis for clinical intervention.
The study cohort included 70 patients with coronary artery stenosis recruited from Zhejiang Provincial Hospital of Traditional Chinese Medicine. The patients were randomly assigned to the intervention group (IC administration of 2 mg/2 ml of nicorandil and 200 μg/2 ml of verapamil) or the control group (IC administration of 2 ml of saline). BP and HR were compared before medication, after medication, and when stabilized.
IC administration of verapamil at 200 μg significantly reduced systolic BP as compared to the control group (113.72 ± 3.40 vs. 123.63 ± 3.33 mmHg, respectively, < 0.05) for a short period of time, and returned to baseline within 2 min, but had no effect on diastolic BP and HR. IC administration injection of nicorandil at 2 mg had no effect on BP or HR. There were no instances of major cardiovascular events.
IC administration of nicorandil at 2 mg is safe as an adjunctive medication during interventional angiography. Verapamil can also be used as an IC adjuvant, although BP and HR must be monitored for patients with low basal BP, especially systolic BP.
尼可地尔和维拉帕米可在经皮冠状动脉介入治疗期间改善冠状动脉血流和冠状动脉微循环。然而，冠状动脉内（IC）给予尼可地尔和维拉帕米对血流动力学的影响仍不清楚。
阐明冠状动脉内给予尼可地尔和维拉帕米对血压（BP）和心率（HR）的安全性和影响，为临床干预提供循证依据。
研究队列包括从浙江省中医院招募的70例冠状动脉狭窄患者。患者被随机分配至干预组（冠状动脉内给予2mg/2ml尼可地尔和200μg/2ml维拉帕米）或对照组（冠状动脉内给予2ml生理盐水）。比较用药前、用药后及病情稳定时的血压和心率。
与对照组相比，冠状动脉内给予200μg维拉帕米可在短时间内显著降低收缩压（分别为113.72±3.40与123.63±3.33mmHg，P<0.05），并在2分钟内恢复至基线水平，但对舒张压和心率无影响。冠状动脉内给予2mg尼可地尔对血压或心率无影响。未发生重大心血管事件。
冠状动脉内给予2mg尼可地尔作为介入血管造影期间的辅助用药是安全的。维拉帕米也可作为冠状动脉内辅助用药，尽管对于基础血压较低尤其是收缩压较低的患者必须监测血压和心率。
