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Immediate Effect of Sublingual Isosorbide Dinitrate in Patients with Coronary Slow Flow Phenomenon (CSFP) |
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PP: 49-55 |
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doi:10.18576/ab/010204
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Author(s) |
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Hassam Mansour,
Ramadan Ghaleb,
Hassan Ellaban,
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Abstract |
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| The coronary slow flow phenomenon (CSFP) is defined angiographically by delayed opacification of the distal vasculature in the absence of obstructive coronary artery disease. Recently, literatures are in favor of the coronary microvascular disorder hypothesis. In spite of its clinical impact and the explicit clinical equipoise in its management, only few studies are held to set clear guidelines.
Aim: We aimed to investigate the immediate effect of sublingual Isosorbide Dinitrate (ISDN) on Thrombolysis in Myocardial Infarction (TIMI) flow through assessment of total frame counts (TFCs) during coronary angiography.
Methods: A non-randomized interventional trial, the first eligible Thirty two CSFP patients presented to cathlab department at October 6th University were enrolled, a baseline angiographic picture assessment to check for eligibility and confirm safety parameters then sublingual 5mg of isosorbide dinitrate was administered followed by a follow up angiographic pictures one minute after isosorbide dinitrate administration for each participant, then coronary flow was compared before and one minute after isosorbide dinitrate administration . Heart rate, systolic and diastolic blood pressures, and TFCs in all 3 coronaries were recorded and the correction was done for LAD at a baseline assessment after study drug assignment.
Study population characteristics were respectively male to female 19 to 13, DM versus non DM were 13 versus 19, HTN versus non HTN were 19 versus 13, smoking versus nonsmoking 22 versus 10, Dyslipidemic versus normo lipidemics were 12 versus 20; the mean age was 54 ± 11 years.
Results: Significant cTFC changes among observations were detected by simple t-test comparisons, then a descriptive statistical analysis were carried out for percentage change between baseline and the post-treatment TFCs. In addition to covariance analysis (ANCOVA) with baseline score as a covariate for all variables.
Comparative TFCs angiography showed that TFCs were significantly lower in overall, (mean decrease of 95% CI- 35.2 %) showing a statistically significant TFCs reduction in all coronaries
Conclusion: Comparative angiographic TFCs and hemodynamic effects showed that TFCs were significantly lower after isosorbide dinitrate sublingual administration; this was associated with significant angiographic and clinical improvement without substantial hemodynamic changes. |
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