Fasudil combined with nitroglycerin in treatment of unstable angina pectoris

Abstract

Objective To investigate the effect of Rho/Rho-kinase inhibitor fasudil combined with conventional vasodilating agents nitroglycerin in treatment of unstable angina pectoris.Methods Twenty patients[mean age (61 ± 11) years old]with unstable angina pectoris (angiospasm in the left anterior descending coronary artery) were selected and divided into fasudil group and control group with 10 cases each by random digits table.All the patients were examined by the acetylcholine stress test.Coronary diameter at the spasm site was measured and compared at baseline and after the administration of nitroglycerin in the following order: intracoronary nitroglycerin (300 g), intravenous fasudil (30 mg, fasudil group) or saline (control group), and again nitroglycerin (300 g) during coronary angiography.Results There was no significant difference in coronary diameter at the first nitroglycerin administration between fasudil group and control group[(38.2 ± 23.6)% vs.(42.6 ± 17.2)% ,P ＞0.05].Coronary diameter at intravenous fasudil and again nitroglycerin administration in fasudil group was expanded, and there was significant difference compared with that of the first nitroglycerin administration[(2.48 ±0.79), (2.51 ± 0.78 ) mm vs.( 2.11 ± 0.62 ) mm](P ＜ 0.01 ), but there was no significant difference in control group (P ＞ 0.05).There was no adverse effect in two groups,and blood pressure and heart rate was stable in fasudil group.Conclusions Fasudil further dilates the site of coronary spasm, which had already been treated with nitroglycerin in patients with vasospastic angina.These findings support and extend the previous results that shows the feasibility of employing fasudil as a novel therapeutic approach for coronary spasm. Key words: Angina,unstable; Fasudil; Acetylcholine stress test