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Utility and Validity of Intracoronary Administration of Nicorandil Alone for the Measurement of Fractional Flow Reserve in Patients With Intermediate Coronary Stenosis.
- Source :
-
Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2019 Sep 25; Vol. 83 (10), pp. 2010-2016. Date of Electronic Publication: 2019 Aug 14. - Publication Year :
- 2019
-
Abstract
- Background: Intracoronary (IC) administration of nicorandil has been proposed as an alternative choice of hyperemic agent for fractional flow reserve (FFR) measurements. This study evaluated the utility and validity of IC nicorandil administration alone to induce maximal hyperemia.Methods and Results:Two-hundred-seven patients with coronary artery disease listed for coronary angiography with FFR were prospectively enrolled. FFR was measured after (1) IC administration of nicorandil 2 mg (ICNIC2 mg); (2) continuous intravenous (IV) adenosine triphosphatase (ATP) infusion at 150 μg/kg/min (IVATP150); (3) IV ATP infusion at 210 μg/kg/min (IVATP210); (4) IC administration of 0.5 mg nicorandil during IVATP150 (ICNIC0.5 mg+IVATP150); (5) IC administration of 1 mg nicorandil during IVATP150 (ICNIC1 mg+IVATP150); and (6) IC administration of 2 mg nicorandil during IVATP150 (ICNIC2 mg+IVATP150). The average FFR values and the rate of achieving maximum hyperemia after ICNIC2 mg, IVATP150, IVATP210, ICNIC0.5 mg+IVATP150, ICNIC1 mg+IVATP150, and ICNIC2 mg+IVATP150 were 0.85±0.08, 0.89±0.08, 0.85±0.09, 0.84±0.08, 0.83±0.08, 0.83±0.08 (P<0.01), and 92%, 54%, 91%, 96%, 99%, 99% (P<0.01), respectively. The incidence of systolic aortic pressure drop, chest discomfort, and transient atrioventricular block increased in a dose-dependent manner after IV ATP infusion, but almost no adverse effects were observed after ICNIC2 mg.<br />Conclusions: ICNIC2 mg produced a more pronounced hyperemia than continuous IV ATP, and might be the preferred method for assessment of FFR.
- Subjects :
- Adenosine Triphosphate administration & dosage
Adult
Aged
Aged, 80 and over
Angina Pectoris physiopathology
Coronary Angiography
Coronary Stenosis physiopathology
Coronary Vessels diagnostic imaging
Female
Humans
Hyperemia physiopathology
Infusions, Intravenous
Male
Middle Aged
Nicorandil adverse effects
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Time Factors
Vasodilator Agents adverse effects
Young Adult
Angina Pectoris diagnosis
Cardiac Catheterization
Coronary Stenosis diagnosis
Coronary Vessels physiopathology
Fractional Flow Reserve, Myocardial
Nicorandil administration & dosage
Vasodilator Agents administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1347-4820
- Volume :
- 83
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Circulation journal : official journal of the Japanese Circulation Society
- Publication Type :
- Academic Journal
- Accession number :
- 31413232
- Full Text :
- https://doi.org/10.1253/circj.CJ-19-0421