Comparison of the Effects of Nicorandil and Cocktail Solution to Prevent Radial Artery Spasm during Coronary Angiography

Kim, Seong Hwan; Kim, Eung Ju; Kim, Min Kyu; Yun, In Sang; Park, Woo Jung; Han, Sang Jin; Cho, Goo Yeong; Choi, Young Jin; Hong, Kyung Soon; Han, Kyoo Rok; Oh, Dong Jin; Rhim, Chong Yun

Abstract

BACKGROUND AND OBJECTIVES: A radial artery spasm is one of the most common complications of coronary angiography during a transradial, causing considerable patient discomfort, which sometimes disturbs the procedure. This study was designed to evaluate the effects of nicorandil in the prevention of a radial artery spasm during coronary angiography.
SUBJECTS AND METHODS
This was a randomized study to compare 4 mg of nicorandil and a 10 mL cocktail solution performed in 100 patients. Vasospasms of the radial artery, which were expressed as stenosis of the vessel diameter with a transradial approach and radial artery patency by pulse oximetry analysis one month later, were examined.
RESULTS
Reductions in the systolic and diastolic blood pressures after administration of the spasmolytic agents were 15.8+/-11.8/ 8.4+/-8.0 and 20.5+/-13.6/6.7+/-6.2 in the for nicorandil and cocktail groups, respectively. Nicorandil induced a lesser decrease in the systolic BP than the cocktail, but without statistical significance (p=0.07). Both vasodilating agents showed a significant radial artery vasodilation following their intra-arterial administration (p<0.001 for all). The diameter of the radial artery showed a significant decrease in both groups following catheterization (p<0.05 for all). There were no significant differences between the two groups in terms of radial artery spasms (46 vs. 58% in nicorandil and cocktail groups, respectively, p=0.709).
CONCLUSION
Nicorandil, with vasodilatory effects due to a dual mechanism was as effective as the cocktail solution in the vasodilation of the radial artery.