Author Interviews, Heart Disease / 22.03.2017
Intracoronary Nitroglycerin, the Forgotten Stepchild of Cardiovascular Guidelines
MedicalResearch.com Interview with:
Alec Vishnevsky, MD
Cardiology Fellow and First Author
Thomas Jefferson University Hospital
Michael P. Savage, MD FACC FSCAI FACP
Ralph J. Roberts Professor of Cardiology
Sidney Kimmel Medical College at Thomas Jefferson University
Director, Cardiac Catheterization Laboratory
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Percutaneous coronary intervention (PCI) has been a mainstay treatment for patients with symptomatic coronary artery disease. While current guidelines emphasize the importance of periprocedural antithrombotic medications, they fail to mention the use of nitroglycerin prior to PCI to rule out coronary artery spasm as the etiology of a stenosis seen on coronary angiography. This distinction is paramount as it can avoid unnecessary stenting procedures.
In this case series, we described a series of patients presenting with chest pain and angiographically significant stenoses that resolved with administration of intracoronary nitroglycerin (IC NTG) prior to planned PCI. The study group consisted of 6 patients with a mean age of 52, all of whom had anginal symptoms and significant stenoses seen on coronary angiogram. In each case, giving intracoronary nitroglycerin resulted in resolution of the stenosis, and all 6 patients were successfully managed medically without stenting.
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