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静脉内尼卡迪平与维拉帕米尔在跨射线接入冠状动脉导管治疗期间

Keshav Patel¹, Melissa Duckett², Mladen I Vidovich²

¹Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America.

Cardiovascular revascularization medicine : including molecular interventions

|August 27, 2024

概括

静脉内尼卡迪平在跨射线通道 (TRA) 心脏导管治疗过程中比维拉帕米尔引起的不适程度要小. 这两种血管扩张剂都能有效地预防放射性动脉 (RAS),发病率低.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
血管接入血管接入

背景情况:

动脉内 (IA) 血管扩张剂对于在跨射线接入 (TRA) 期间预防放射性动脉 (RAS) 是至关重要的.
美国心脏协会 (AHA) 目前的指导方针建议使用IA维拉帕米尔,迪尔提亚泽姆,尼卡迪平或尼甘油.
关于维拉帕米尔与尼卡迪平在RAS预防中的有效性和患者耐受性的直接比较数据有限.

研究的目的:

为了比较患者报告的与IA尼卡迪平与IA维拉帕米尔管理相关的不适和疼痛.
评估尼卡迪平和维拉帕米尔在TRA过程中预防RAS的疗效.

主要方法:

进行了一项前性,单盲随机临床试验.
患者接受了400微克的IA尼卡迪平 (n=26) 或5毫克的IA维拉帕米尔 (n=29).
患者的不适和疼痛被使用视觉模拟量表 (VAS) 评估,用于IA前后的管理.

主要成果:

观察到平均VAS得分变化的统计学上显著差异,尼卡迪平组 (0.88) 与维拉帕米尔组 (4.81) 相比,尼卡迪平组的增加较小 (p < 0.0001).
RAS的总体发病率很低 (5.5%),并且在各组之间没有显著差异 (p = 0.465).
RAS发生在7.7%的尼卡迪平组 (1例需要改变策略) 和3.4%的维拉帕米尔组 (没有改变策略).

结论:

与IA维拉帕米尔相比,IA尼卡尔迪平在TRA过程中对患者的不适和疼痛显著减少.
尼卡迪平和维拉帕米尔都显示RAS的发病率较低,这表明在预防方面具有相似的有效性.
尼卡迪平可能是TRA中IA的首选药物,因为它可以改善患者的耐受性.

关键词:

通道阻塞剂通道阻塞剂心脏导管治疗的心脏导管治疗动脉内部的动脉内.尼加尔迪平是尼加尔迪平的一种药物.跨射线接入跨射线接入维拉帕米尔 (Verapamil) 是一种药物.

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