Prospective,randomized and double-blind study on prevention of radial artery spasm / 中国介入心脏病学杂志

ABSTRACT

Objective To compare the effect of different dosage of verapamil and a cocktail therapy(verapamil 200 ?g plus nitroglycerin 200 ?g) in the prevention of radial artery spasm(RAS) during transradial PCI.Methods It is a prospective,randomized and double-blind clinical trial.Patients who received transradial coronary intervention were divided into three groups: group A(verapamil 200 ?g),group B(verapamil 1mg) and group C(verapamil 200 ?g plus nitroglycerin 200 ?g).Different drug protocols were given randomly to the patients after sheath insertion.The diagnostic criteria is clinical definition of RAS documented by angiography.The incidence of RAS and adverse effects in each group was compared.Results A total of 621 patients were enrolled,and there were 205 in group A,207 in group B and 210 in group C.The baseline characteristics were of no difference among the three groups.Univariate analysis showed that the incidence of RAS in group A is higher than that in group B(17.1% vs.10.2%,P=0.045) and in group C(17.1% vs.9.5%,P=0.029),but there was no statistical difference in the RAS incidence between group B and C(10.2% vs.9.5%,P=0.870).Binary logistic regression analysis showed that the relative risk of RAS in group B decreased by 32.1% compared with group A(P=0.038),and the relative risk in group C decreased by 43.8% compared with group A(P=0.017).The incidences of adverse effect were similar in groups A and C,but was higher in group B when compared with group A(9.7% vs.2.4%,P=0.003) and C(9.7% vs.3.8%,P=0.019),respectively.Conclusion Verapamil 200 ?g plus nitroglycerin 200 ?g is recommended to prevent RAS during transradial coronary intervention in Chinese.