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Ann Thorac Surg 1990;49:61-68
© 1990 The Society of Thoracic Surgeons
II. Department of Surgery, Department of Anaesthesia and Intensive Care, and Department of Cardiology, University of Vienna, Austria
* Address reprint requests to Dr Seitelberger, II. Department of Surgery, University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
We performed a randomized study on patients undergoing elective coronary bypass grafting to examine whether postoperative infusion of nifedipine (n = 25) could reduce the incidence of isolated transient myocardial ischemia, myocardial infarction, or both. The control group (n = 25) received nitroglycerin. Hemodynamic and Holter monitoring and serial assessment of enzymatic and electrocardiographic changes were performed for all patients. Both groups showed comparable preoperative and operative data. The incidence of myocardial infarction was significantly lower in the nifedipine group (n = 1) as compared with the control group (n = 4), whereas the number of patients with isolated transient myocardial ischemia was similar in both groups (nifedipine, 3; control, 4). At the time of peak activity, levels of creatine kinase (350 ± 129 versus 511 ± 287 IU/mL), creatine kinase-MB (8.4 ± 5.4 versus 17.1 ± 11.0 IU/mL), and glutamate-oxaloacetate-transaminase (30.4 ± 4.4 versus 41.0 ± 7.9 IU/mL) were markedly lower in the nifedipine group (< 0.05). We conclude that infusion of nifedipine after elective coronary artery bypass grafting effectively decreases the incidence of myocardial infarction and the extent of myocardial necrosis during the early postoperative period.
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