IC Nicardipine Promising for Tx of Spontaneous Coronary Slow-Flow
WEDNESDAY, Jan. 9, 2019 -- Intracoronary (IC) administration of nicardipine seems to be highly effective in reversing spontaneous coronary slow-flow (CSF), according to a study published online Dec. 15 in the Journal of Invasive Cardiology.
Hetal H. Mehta, M.D., from Thomas Jefferson University Hospital in Philadelphia, and colleagues evaluated the effect of IC nicardipine in 30 patients (22 men; mean age, 54 years) with CSF (defined as spontaneously delayed flow [<TIMI 3] during diagnostic coronary angiography in the absence of obstructive epicardial coronary artery disease or other conditions). A 200-microgram IC bolus of nicardipine was administered after which repeat angiography was performed.
The researchers found CSF in 49 vessels at baseline. TIMI frame count (TFC) was prolonged (>27) in 68 of the 90 vessels. Administration of IC nicardipine produced markedly accelerated coronary filling, which was verified by TFC analysis. TFC was 47 before nicardipine versus 15 after. After nicardipine treatment, all vessels showed TIMI 3 flow and TFC <28.
"These findings implicate microvascular spasm in the pathogenesis of CSF," the authors write. "Future studies of oral calcium-channel blockers in the long-term management of CSF are needed."
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Posted: January 2019