Effect of transradial catheterization and nifedipine on flow- and nitroglycerin-mediated dilations of distal and proximal radial artery.

Abstract

Radial artery (RA) dysfunction after transradial access intervention is not limited to the distal portion but can also occur in the proximal portion of RA. The aim of the present study was to assess the effect of sublingual nifedipine administrated prior to puncture on the endothelial function of distal and proximal RA. Eighty-nine patients who underwent coronary angiography (CAG) were randomly assigned to the nifedipine group ( n = 45) or control group ( n = 44). The flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) of distal and proximal RA were measured at baseline, 24 h, and 48 h after transradial angiography. Compared with the control group, the nifedipine group only limited the reduction of FMD in the distal RA at 24 and 48 h [6.52 ± 1.40% (24 h) vs. 5.85 ± 1.38% (24 h), P = 0.03; 7.41 ± 1.30% (48 h) vs. 6.65 ± 1.25% (48 h), P = 0.006], whereas FMD alterations in the proximal RA were not restored by nifedipine. Both groups were still lower than baseline values (11.66 ± 2.35% and 11.24 ± 2.22%). We observed similar effects of nifedipine on the NMD of the distal RA. Although transradial angiography-induced dysfunction was reported in both distal and proximal RA, nifedipine could help restore the distal endothelial function of the cannulated RA.