Publication: Comparison of efficacy and safety of intracoronary nicardipine and adenosine for fractional flow reserve assessment of coronary stenosis
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Issued Date
2022
Resource Type
Language
eng
File Type
application/pdf
ISSN
1675273
Rights Holder(s)
Scopus
Bibliographic Citation
Dentistry Journal. Vol 10, No.8 (2022)
Suggested Citation
Roongsangmanoon W., Wongsoasup A., Angkananard T., Rattanajaruskul N., Jirapattrathamrong S. Comparison of efficacy and safety of intracoronary nicardipine and adenosine for fractional flow reserve assessment of coronary stenosis. Dentistry Journal. Vol 10, No.8 (2022). doi:10.1016/j.ijcard.2022.04.008 Retrieved from: https://hdl.handle.net/20.500.14740/10374
Abstract
Background: Administration of intracoronary (IC) adenosine allows an easily feasible, inexpensive, and more rapid alternative method for fractional flow reserve (FFR). It is common practice in many centers worldwide. Nicardipine is a strong coronary vasodilator but its efficacy and safety for assessing FFR is not established. The purpose of present study was to compare the efficacy and safety of IC nicardipine and adenosine for assessing FFR. Methods: One hundred and fifty-nine patients with a total of 193 vessels undergoing clinically indicated FFR assessment of intermediate coronary stenoses were included. For the initial assessment of FFR, hyperemia was induced by an IC adenosine. After a washout period of 3 min, FFR was reassessed using 200 μg of IC nicardipine. Results: Hyperemic efficacy among two different stimuli was compared. The mean FFR with IC adenosine was 0.83 ± 0.09 and that with an IC nicardipine was 0.84 ± 0.09. The median FFR with an IC adenosine was 0.83 (0.78–0.91) and that with an IC nicardipine was 0.85 (0.79–0.91) (p-value 0.246). Both FFR values showed an excellent correlation (R2 = 0.982, p < 0.001). Nicardipine produced fewer changes in heart rate, less chest pain and less flushing than adenosine. Transient atrioventricular block occurred in 29 patients with IC adenosine and none with IC nicardipine. Conclusions: IC bolus injection of nicardipine could be introduced as a safe and practical alternative method of inducing hyperemia during FFR measurements. Compared to IC adenosine, IC nicardipine has a similar hyperemic efficacy and excellent side-effect profile. © 2022 Elsevier B.V.