open access

Vol 65, No 7 (2007)
Other
Published online: 2007-07-24
Submitted: 2012-12-28
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Original article
Nitroglycerin infusion after percutaneous coronary intervention does not influence short- and long-term outcome – a prospective NAPI (Nitroglycerin Administration after Percutaneous Intervention)* study

Jakub Foryś, Jan Peruga, Michał Plewka, Piotr Lipiec, Aleksandra Jasińska, Maria Krzemińska-Pakuła, Jarosław Kasprzak
Kardiol Pol 2007;65(7):798-803.

open access

Vol 65, No 7 (2007)
Other
Published online: 2007-07-24
Submitted: 2012-12-28

Abstract


Background: Although the benefit of nitroglycerin infusion in patients after elective coronary angioplasty has not been established, this regimen is routinely used in some centres.
Aim: The Nitroglycerin Administration after Percutaneous Intervention (NAPI) study tested the efficacy of routine nitroglycerin infusion on the 1st day after percutaneous coronary intervention (PCI) in a double-blind randomised single-centre clinical trial.
Methods. We randomly assigned 200 patients scheduled for elective PCI to treatment with nitroglycerin (100 patients, age 58±6 years, infusion up to 100 µg/min) or placebo (100 patients, age 57±5 years, p=NS, NaCl 0.9%) for 12 hours after PCI. Patients with acute myocardial infarction, haemodynamic instability during PCI and known intolerance to nitrates were excluded. Patients who were randomised to the placebo group had the possibility to receive nitroglycerin infusion according to the attending physician’s decision. Clinical endpoints (cardiac death, myocardial infarction, postprocedural chest pain, unstable angina and repeated PCI) were assessed in hospital and out of hospital with follow-up extended to 24 months.
Results: There were no differences during in-hospital stay between those receiving nitroglycerin and receiving placebo, regarding mortality (0 vs. 0%, NS), myocardial infarction (0 vs. 2%, NS), postprocedural chest pain (10 vs. 8%, NS) or repeated PCI (0 vs. 2%, NS). Similarly, 24-month follow-up also revealed no significant differences between those receiving nitroglycerin and placebo (mortality: 0 vs. 0%, NS; myocardial infarction: 4 vs. 4%, NS; repeated PCI: 10 vs. 8%, NS or CABG: 0 vs. 0%, NS).
Conclusions: Routine use of intravenous nitroglycerin after elective PCI has no influence on in-hospital and long-term outcome, including cardiac death, myocardial infarction, postprocedural chest pain, unstable angina and repeated PCI.

Abstract


Background: Although the benefit of nitroglycerin infusion in patients after elective coronary angioplasty has not been established, this regimen is routinely used in some centres.
Aim: The Nitroglycerin Administration after Percutaneous Intervention (NAPI) study tested the efficacy of routine nitroglycerin infusion on the 1st day after percutaneous coronary intervention (PCI) in a double-blind randomised single-centre clinical trial.
Methods. We randomly assigned 200 patients scheduled for elective PCI to treatment with nitroglycerin (100 patients, age 58±6 years, infusion up to 100 µg/min) or placebo (100 patients, age 57±5 years, p=NS, NaCl 0.9%) for 12 hours after PCI. Patients with acute myocardial infarction, haemodynamic instability during PCI and known intolerance to nitrates were excluded. Patients who were randomised to the placebo group had the possibility to receive nitroglycerin infusion according to the attending physician’s decision. Clinical endpoints (cardiac death, myocardial infarction, postprocedural chest pain, unstable angina and repeated PCI) were assessed in hospital and out of hospital with follow-up extended to 24 months.
Results: There were no differences during in-hospital stay between those receiving nitroglycerin and receiving placebo, regarding mortality (0 vs. 0%, NS), myocardial infarction (0 vs. 2%, NS), postprocedural chest pain (10 vs. 8%, NS) or repeated PCI (0 vs. 2%, NS). Similarly, 24-month follow-up also revealed no significant differences between those receiving nitroglycerin and placebo (mortality: 0 vs. 0%, NS; myocardial infarction: 4 vs. 4%, NS; repeated PCI: 10 vs. 8%, NS or CABG: 0 vs. 0%, NS).
Conclusions: Routine use of intravenous nitroglycerin after elective PCI has no influence on in-hospital and long-term outcome, including cardiac death, myocardial infarction, postprocedural chest pain, unstable angina and repeated PCI.
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Keywords

elective PCI; nitrates; percutaneous coronary angioplasty

About this article
Title

Original article
Nitroglycerin infusion after percutaneous coronary intervention does not influence short- and long-term outcome – a prospective NAPI (Nitroglycerin Administration after Percutaneous Intervention)* study

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 7 (2007)

Pages

798-803

Published online

2007-07-24

Bibliographic record

Kardiol Pol 2007;65(7):798-803.

Keywords

elective PCI
nitrates
percutaneous coronary angioplasty

Authors

Jakub Foryś
Jan Peruga
Michał Plewka
Piotr Lipiec
Aleksandra Jasińska
Maria Krzemińska-Pakuła
Jarosław Kasprzak

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