Is vitamin C superior to diltiazem for radial artery vasodilation in patients awaiting coronary artery bypass grafting?

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Ημερομηνία

Συγγραφείς

Drossos, G. E.
Toumpoulis, I. K.
Katritsis, D. G.
Ioannidis, J. P.
Kontogiorgi, P.
Svarna, E.
Anagnostopoulos, C. E.

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Περίληψη

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Είδος δημοσίευσης σε συνέδριο

Είδος περιοδικού

peer-reviewed

Είδος εκπαιδευτικού υλικού

Όνομα συνεδρίου

Όνομα περιοδικού

J Thorac Cardiovasc Surg

Όνομα βιβλίου

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Έκδοση βιβλίου

Συμπληρωματικός/δευτερεύων τίτλος

Περιγραφή

OBJECTIVES: We aimed to measure the vasodilating effects of vitamin C on the radial arteries of healthy subjects and to assess whether vitamin C is superior in this regard to diltiazem, a commonly used vasodilator in coronary artery bypass using radial conduits. METHODS: In a case-control study (study 1) oral single-dose vitamin C (2 g) was given to 15 healthy nonsmokers and 15 matched otherwise healthy smokers. In a randomized double-blind study (study 2) oral single-dose vitamin C (2 g, n = 15) and diltiazem (180 mg, n = 15) were compared in preoperative patients with coronary artery disease. We examined the dilation of the radial artery with high-resolution ultrasonography and measurement of the lumen surface and color Doppler images of the nondominant radial artery just before and 2 hours after drug administration. RESULTS: In study 1 both smokers and nonsmokers showed a significant increase in the lumen surface at 2 hours compared with at baseline (P <.001 and P =.013, respectively). The increase was larger in smokers (median, 37.5% vs 14.3%; P =.004). In study 2 both groups showed statistically significant increases in the lumen surface at 2 hours compared with at baseline (P <.001 and P =.008 for vitamin C and diltiazem, respectively). Vitamin C achieved a larger increase than diltiazem (median, 33.3% vs 18.2%; P =.016). In multivariate modeling the increase in lumen surface was independently predicted by use of vitamin C over diltiazem (+21.2%, P =.007), diabetes mellitus (+14.5%, P =.085), increased cholesterol (+26.2%, P =.001), and smoking history (+20.8%, P =.017). CONCLUSIONS: Vitamin C is a potent acute vasodilator in both smokers and nonsmokers and is superior to diltiazem in preoperative coronary patients who need protection from vasospasm of the radial conduit.

Περιγραφή

Λέξεις-κλειδιά

Adult, Aged, Ascorbic Acid/pharmacology/*therapeutic use, Case-Control Studies, Coronary Artery Bypass/*methods, Coronary Disease/*drug therapy/etiology/physiopathology/surgery/ultrasonography, Diabetes Complications, Diltiazem/pharmacology/*therapeutic use, Double-Blind Method, Female, Humans, Hypercholesterolemia/complications, Male, Middle Aged, Multivariate Analysis, Pilot Projects, Predictive Value of Tests, Radial Artery/*drug effects/physiopathology/*transplantation/ultrasonography, Smoking/adverse effects/*drug therapy/physiopathology, Ultrasonography, Doppler, Color, Vasodilation/*drug effects, Vasodilator Agents/pharmacology/*therapeutic use

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http://www.ncbi.nlm.nih.gov/pubmed/12579102
http://ac.els-cdn.com/S0022522302732509/1-s2.0-S0022522302732509-main.pdf?_tid=a174db30884480662f80e7e4aca4d7a0&acdnat=1333364520_cc26c5666019de8cf37c7a41d41c736b

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en

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Γενική Περιγραφή / Σχόλια

Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος

Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής

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