Cardioprotective effects of diltiazem infusion in the perioperative period

Malhotra, Rajneesh; Mishra, Manisha; Kler, T.S.; Kohli, Vijay; Mehta, Yatin; Trehan, Naresh

doi:10.1016/s1010-7940(97)00140-1

Cited by 29 publications

(11 citation statements)

References 19 publications

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“…Nevertheless, many studies support our data, suggesting that perioperative diltiazem infusion does not produce any negative inotropic effect in patients undergoing CABG. 20 Electrocardiographic monitoring of arrhythmias showed no significant differences between the two groups. However, diltiazem may cause low heart rate or hypotension in some patients.…”

Section: Discussionmentioning

confidence: 83%

Diltiazem versus Amiodarone to Prevent Atrial Fibrillation in Coronary Surgery

Mikroulis

Didilis

Konstantinou

et al. 2005

Asian Cardiovasc Thorac Ann

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The prophylactic effect of amiodarone on atrial fibrillation after coronary bypass grafting with extracorporeal circulation was compared with that of diltiazem in two groups of 60 patients each. Patients were monitored continuously for 8 days. The incidence of atrial fibrillation was recorded retrospectively in a control group of 60 patients who received our standard prophylactic regimen of an oral beta blocker. The incidence of postoperative atrial fibrillation was not significantly different in the two test groups: 11.7% for the amiodarone group and 10% for the diltiazem group. The incidence of atrial fibrillation in the control group was 23.3% and the differences were marginally significant when compared to the amiodarone ( p = 0.093) and diltiazem groups ( p = 0.050). The prophylactic use of diltiazem or amiodarone is feasible and safe for patients undergoing coronary bypass, with similar rates of atrial fibrillation.

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Section: Discussionmentioning

confidence: 83%

Diltiazem versus Amiodarone to Prevent Atrial Fibrillation in Coronary Surgery

Mikroulis

Didilis

Konstantinou

et al. 2005

Asian Cardiovasc Thorac Ann

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“…Применение АК сопровождалось более частой необходимостью электростимуляции сердца (ОР=6,57; 95%ДИ=3,54-12,18; р<0,001) без значительной гетерогенности по подклассам (различия по критерию χ 2 =0,50; р=0,78). В 3 исследованиях изучали кровопотерю в послеоперационном периоде [22,23,39]. Различия в группе активной терапии и контрольной группе были недостоверными (различия составили -0,47 мл; р=1,0 без различий по подклассам (различия по критерию χ 2 =1,70; р=0,43).…”

Section: св недогода волгоградский государственный медицинский унивunclassified

Application of Calcium Antagonists in Prevention of Cardiovascular Complications During Cardiac Surgery

Недогода

2006

Racionalʹnaâ farmakoterapiâ v kardiologii

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Применение антагонистов кальция для профилактики сердечно-сосудистых осложнений при операциях на сердце С.В. Недогода Волгоградский государственный медицинский университет Рассматриваются результаты рандомизированных клинических исследований по применению антагонистов кальция (АК) с целью предупреждения периоперационных осложнений при аортокоронарном шунтировании и операциях на клапанах сердца. АК уменьшали риск развития периоперационных инфарктов и эпизодов обратимой ишемии миокарда. После ангиопластики коронарных артерий АК (в частности амлодипин) оказывают положительное влияние на частоту рестенозов и почти в 3 раза снижают число повторных ангиопластик и операций аортокоронарного шунтирования. Применение АК сопровождалось более частой необходимостью электростимуляции сердца без различий по подклассам. Отмечается также, что нимодипин может усиливать интраоперационную кровопотерю. Делают вывод о том, что АК имеют весомую доказательную базу, позволяющую рекомендовать их применение у кардиохирургических пациентов. Ключевые слова: антагонисты кальция, интраоперационные осложнения, аортокоронарное шунтирование, ангиопластика. РФК 2006; 3: 56-64 Application of calcium antagonists in prevention of cardiovascular complications during cardiac surgery S.V. Nedogoda Volgograd Medical State University Results of randomized clinical trials on the usage of calcium antagonists (CA) in order to prevent perioperative complications during aortocoronary bypass procedure and operations on heart valves are analyzed. CA reduced the risk of perioperative myocardial infarctions and episodes of reversible myocardial ischemia. After angioplasty of coronary arteries CA (particularly amlodipine) show positive effects on restenosis incidence and reduce about 3 times a number of repeated angioplasty and aortocoronary bypass operations. The use of CA was accompanied by more often need in heart electro stimulation without any subclass differences. It is also registered that nimodipine can strengthen intraoperative blood loss. It is concluded, that CA have significant evident base that allows recommending them to patients undertaken by cardiological surgery.

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“…Während die Gabe von Diltiazem bei kardochirurgischen Patienten zu einer Reduktion perioperativer Myokardischämien führte [27,30], konnte für Nifedipin kein positiver Effekt gefunden werden [9,52]. In einer aktuellen Untersuchung wird sogar eine negative Wirkung von Kalziumantagonisten auf die Häufigkeit perioperativer Ischämien beschrieben [50].…”

Section: Kalziumantagonistenunclassified

Der kardiale Risikopatient in der Anästhesie

Baumert¹,

Buhre²

2001

Der Anaesthesist

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Perioperative cardiac morbidity is one of the main challenges to the anaesthesiologist. Because of demographic changes and the increased prevalence of coronary artery disease (CAD) in elderly patients, the number of those at risk is increasing. Special attention has to be paid to patients bearing an increased risk where CAD has not been proven preoperatively because they represent the majority. The use of the "Revised Cardiac Risk Index", which includes patient-related as well as surgery-related risk, is recommended as its predictive value is validated to be very high. Additional preoperative testing is indicated only in those patients at intermediate risk where functional status is poor or unclear. In those with clearly high risk, possibility and urgency of an intervention related to their cardiac disease must be weighed against urgency and invasiveness of planned non-cardiac surgery. Regarding prophylactic perioperative therapy, only beta-blockers can be recommended on a sufficient basis of clinical data. This treatment is of special value in patients with poor functional status and those undergoing vascular surgery. Postoperative continuation of beta blockade for five to seven days is essential to its success. The usefulness of alpha-2-blockers is not equally well-proven so far. Prevention of perioperative hypothermia can reduce cardiac risk. In addition, there is increasing evidence that thoracic epidural anaesthesia decreases cardiovascular morbidity and mortality.

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Cardioprotective effects of diltiazem infusion in the perioperative period

Abstract: The present study demonstrates that diltiazem infusion provides superior anti-ischemic protection and control of supraventricular arrhythmias as compared to nitroglycerin and does not produce any negative inotropic effect, as demonstrated by transesophageal echocardiography.

Cited by 29 publications

References 19 publications

Diltiazem versus Amiodarone to Prevent Atrial Fibrillation in Coronary Surgery

Diltiazem versus Amiodarone to Prevent Atrial Fibrillation in Coronary Surgery

Application of Calcium Antagonists in Prevention of Cardiovascular Complications During Cardiac Surgery

Der kardiale Risikopatient in der Anästhesie

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