Is vitamin C superior to diltiazem for radial artery vasodilation in patients awaiting coronary artery bypass grafting? (Journal article)

Drossos, G. E./ Toumpoulis, I. K./ Katritsis, D. G./ Ioannidis, J. P./ Kontogiorgi, P./ Svarna, E./ Anagnostopoulos, C. E.

OBJECTIVES: We aimed to measure the vasodilating effects of vitamin C on the radial arteries of healthy subjects and to assess whether vitamin C is superior in this regard to diltiazem, a commonly used vasodilator in coronary artery bypass using radial conduits. METHODS: In a case-control study (study 1) oral single-dose vitamin C (2 g) was given to 15 healthy nonsmokers and 15 matched otherwise healthy smokers. In a randomized double-blind study (study 2) oral single-dose vitamin C (2 g, n = 15) and diltiazem (180 mg, n = 15) were compared in preoperative patients with coronary artery disease. We examined the dilation of the radial artery with high-resolution ultrasonography and measurement of the lumen surface and color Doppler images of the nondominant radial artery just before and 2 hours after drug administration. RESULTS: In study 1 both smokers and nonsmokers showed a significant increase in the lumen surface at 2 hours compared with at baseline (P <.001 and P =.013, respectively). The increase was larger in smokers (median, 37.5% vs 14.3%; P =.004). In study 2 both groups showed statistically significant increases in the lumen surface at 2 hours compared with at baseline (P <.001 and P =.008 for vitamin C and diltiazem, respectively). Vitamin C achieved a larger increase than diltiazem (median, 33.3% vs 18.2%; P =.016). In multivariate modeling the increase in lumen surface was independently predicted by use of vitamin C over diltiazem (+21.2%, P =.007), diabetes mellitus (+14.5%, P =.085), increased cholesterol (+26.2%, P =.001), and smoking history (+20.8%, P =.017). CONCLUSIONS: Vitamin C is a potent acute vasodilator in both smokers and nonsmokers and is superior to diltiazem in preoperative coronary patients who need protection from vasospasm of the radial conduit.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Adult,Aged,Ascorbic Acid/pharmacology/*therapeutic use,Case-Control Studies,Coronary Artery Bypass/*methods,Coronary Disease/*drug therapy/etiology/physiopathology/surgery/ultrasonography,Diabetes Complications,Diltiazem/pharmacology/*therapeutic use,Double-Blind Method,Female,Humans,Hypercholesterolemia/complications,Male,Middle Aged,Multivariate Analysis,Pilot Projects,Predictive Value of Tests,Radial Artery/*drug effects/physiopathology/*transplantation/ultrasonography,Smoking/adverse effects/*drug therapy/physiopathology,Ultrasonography, Doppler, Color,Vasodilation/*drug effects,Vasodilator Agents/pharmacology/*therapeutic use
ISSN: 0022-5223
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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