Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft
Aim. To assess the effect of a pharmacological protocol for the prevention of radial artery spasm, which is based on the systemic and local use of dihydropyridine calcium channel blockers, on the long-term outcomes of autoarterial coronary artery bypass grafting.Material and methods. According to th...
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| Format: | Article |
| Language: | Russian |
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«FIRMA «SILICEA» LLC
2022-09-01
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| Series: | Российский кардиологический журнал |
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| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/4744 |
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| author | V. V. Zatolokin Yu. Yu. Vechersky D. V. Manvelyan B. N. Kozlov |
| author_facet | V. V. Zatolokin Yu. Yu. Vechersky D. V. Manvelyan B. N. Kozlov |
| author_sort | V. V. Zatolokin |
| collection | DOAJ |
| description | Aim. To assess the effect of a pharmacological protocol for the prevention of radial artery spasm, which is based on the systemic and local use of dihydropyridine calcium channel blockers, on the long-term outcomes of autoarterial coronary artery bypass grafting.Material and methods. According to the protocol, oral nifedipine at a dose of 5 mg/day is prescribed 3 days before surgery. Then, after the radial artery is isolated, the vessel is preserved in a solution of nifedipine (adalat) until it is used. After releasing the clamp from the aorta, a nifedipine (adalat) is infused intravenously at a dose of 0,63 mg/h. In the postoperative period, the infusion of nifedipine continues for 6 hours. In the future, patients are recommended to take dihydropyridine calcium channel blockers at a dose of 5 mg/day after discharge from the hospital.Results. The use of the pharmacological protocol (n=225) is associated with a lower number of major cardiovascular events (mortality, myocardial infarction, stroke) compared with the control group (n=230) (9,3% and 15,7%, p=0,031) during the 5-year follow-up. This result was achieved mainly by reducing the incidence of myocardial infarction (6,2% and 12,6%, p=0,018). Also, the use of the pharmacological protocol led to a decrease in repeated revascularizations (4,4% and 16,1%, p=0,0001) compared with the control group.Conclusion. The use of a pharmacological protocol for the prevention of radial artery spasm based on the systemic use of dihydropyridine calcium channel blockers improves the long-term outcomes of autoarterial coronary artery bypass grafting. |
| first_indexed | 2024-04-09T20:43:50Z |
| format | Article |
| id | doaj.art-e2371115f7d944fc8b763f4de405cf24 |
| institution | Directory Open Access Journal |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| last_indexed | 2024-04-09T20:43:50Z |
| publishDate | 2022-09-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj.art-e2371115f7d944fc8b763f4de405cf242023-03-29T21:23:42Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202022-09-0127810.15829/1560-4071-2022-47443479Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graftV. V. Zatolokin0Yu. Yu. Vechersky1D. V. Manvelyan2B. N. Kozlov3Cardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterAim. To assess the effect of a pharmacological protocol for the prevention of radial artery spasm, which is based on the systemic and local use of dihydropyridine calcium channel blockers, on the long-term outcomes of autoarterial coronary artery bypass grafting.Material and methods. According to the protocol, oral nifedipine at a dose of 5 mg/day is prescribed 3 days before surgery. Then, after the radial artery is isolated, the vessel is preserved in a solution of nifedipine (adalat) until it is used. After releasing the clamp from the aorta, a nifedipine (adalat) is infused intravenously at a dose of 0,63 mg/h. In the postoperative period, the infusion of nifedipine continues for 6 hours. In the future, patients are recommended to take dihydropyridine calcium channel blockers at a dose of 5 mg/day after discharge from the hospital.Results. The use of the pharmacological protocol (n=225) is associated with a lower number of major cardiovascular events (mortality, myocardial infarction, stroke) compared with the control group (n=230) (9,3% and 15,7%, p=0,031) during the 5-year follow-up. This result was achieved mainly by reducing the incidence of myocardial infarction (6,2% and 12,6%, p=0,018). Also, the use of the pharmacological protocol led to a decrease in repeated revascularizations (4,4% and 16,1%, p=0,0001) compared with the control group.Conclusion. The use of a pharmacological protocol for the prevention of radial artery spasm based on the systemic use of dihydropyridine calcium channel blockers improves the long-term outcomes of autoarterial coronary artery bypass grafting.https://russjcardiol.elpub.ru/jour/article/view/4744autoarterial myocardial revascularizationcoronary artery diseaseradial artery |
| spellingShingle | V. V. Zatolokin Yu. Yu. Vechersky D. V. Manvelyan B. N. Kozlov Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft Российский кардиологический журнал autoarterial myocardial revascularization coronary artery disease radial artery |
| title | Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft |
| title_full | Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft |
| title_fullStr | Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft |
| title_full_unstemmed | Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft |
| title_short | Role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft |
| title_sort | role of dihydropyridine calcium channel blockers in coronary bypass surgery using the radial artery graft |
| topic | autoarterial myocardial revascularization coronary artery disease radial artery |
| url | https://russjcardiol.elpub.ru/jour/article/view/4744 |
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