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[PMID]:29489681
[Au] Autor:Kim CO; Song J; Min JY; Park SJ; Lee HM; Byon HJ
[Ad] Endereço:Department of Clinical Pharmacology and Clinical Trials Center, Severance Hospital, Yonsei University Health System, Seodaemun-gu, Seoul.
[Ti] Título:A comparison of the pharmacokinetic and pharmacodynamic properties of nitroglycerin according to the composition of the administration set: A preliminary study.
[So] Source:Medicine (Baltimore);97(9):e9829, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is a risk of drug sorption into an intravenous administration set composed of polyvinyl chloride (PVC), polyurethane (PU), or polyolefin (PO). This has implications on the dose of the active ingredient the patient receives, and thus therapeutic success. This study aimed to determine the plasma concentration of nitroglycerin and the effect of nitroglycerin on patients based on the composition of the administration set. METHODS: Using a randomized, open-labeled, 3 × 3 crossover method, 9 volunteers were assigned to 3 groups. In period I, nitroglycerin (100 µg/mL) was infused via a PVC- (group A), PU- (group B), or PO-based (group C) administration set. In period II, PU- (group A), PO- (group B), and PVC-based (group C) administration sets were used, and in period III, PO- (group A), PVC- (group B), and PU-based (group C) administration sets were used. The rate of drug administration in all periods was 12 mL/hour for 30 minutes using an infusion pump. Blood samples were collected, and the plasma concentrations of nitroglycerin were analyzed using validated high-performance liquid chromatography coupled with tandem mass spectrometry. Blood pressure was determined using a sphygmomanometer applied to the other upper arm at an interval of 5 minutes. RESULTS: We observed that the mean plasma concentration of nitroglycerin over time when administered using a PO-based tube was higher than that when using a PU- or PVC-based tube. When the percent change of the mean arterial pressure from baseline at each time point was compared among groups, there were statistically significant differences between PU and PO or PVC at most points during nitroglycerin infusion. CONCLUSION: Our results showed higher nitroglycerin plasma concentration and lower arterial pressure when a PO-based administration set was used than when a PVC- or PU-based administration set was used. PO-based administration sets may be more appropriate for nitroglycerin administration compared to those composed of PVC or PU.
[Mh] Termos MeSH primário: Administração Intravenosa/instrumentação
Desenho de Equipamento
Bombas de Infusão
Nitroglicerina/farmacocinética
Vasodilatadores/farmacocinética
[Mh] Termos MeSH secundário: Administração Intravenosa/métodos
Adulto
Pressão Sanguínea
Cromatografia Líquida/métodos
Estudos Cross-Over
Seres Humanos
Masculino
Meia-Idade
Nitroglicerina/administração & dosagem
Nitroglicerina/sangue
Polienos
Poliuretanos
Cloreto de Polivinila
Espectrometria de Massas em Tandem
Vasodilatadores/administração & dosagem
Vasodilatadores/sangue
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Polyenes); 0 (Polyurethanes); 0 (Vasodilator Agents); 83136-87-2 (PL 732); 9002-86-2 (Polyvinyl Chloride); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009829


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[PMID]:29096811
[Au] Autor:Divakaran S; Loscalzo J
[Ad] Endereço:Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:The Role of Nitroglycerin and Other Nitrogen Oxides in Cardiovascular Therapeutics.
[So] Source:J Am Coll Cardiol;70(19):2393-2410, 2017 Nov 07.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The use of nitroglycerin in the treatment of angina pectoris began not long after its original synthesis in 1847. Since then, the discovery of nitric oxide as a biological effector and better understanding of its roles in vasodilation, cell permeability, platelet function, inflammation, and other vascular processes have advanced our knowledge of the hemodynamic (mostly mediated through vasodilation of capacitance and conductance arteries) and nonhemodynamic effects of organic nitrate therapy, via both nitric oxide-dependent and -independent mechanisms. Nitrates are rapidly absorbed from mucous membranes, the gastrointestinal tract, and the skin; thus, nitroglycerin is available in a number of preparations for delivery via several routes: oral tablets, sublingual tablets, buccal tablets, sublingual spray, transdermal ointment, and transdermal patch, as well as intravenous formulations. Organic nitrates are commonly used in the treatment of cardiovascular disease, but clinical data limit their use mostly to the treatment of angina. They are also used in the treatment of subsets of patients with heart failure and pulmonary hypertension. One major limitation of the use of nitrates is the development of tolerance. Although several agents have been studied for use in the prevention of nitrate tolerance, none are currently recommended owing to a paucity of supportive clinical data. Only 1 method of preventing nitrate tolerance remains widely accepted: the use of a dosing strategy that provides an interval of no or low nitrate exposure during each 24-h period. Nitric oxide's important role in several cardiovascular disease mechanisms continues to drive research toward finding novel ways to affect both endogenous and exogenous sources of this key molecular mediator.
[Mh] Termos MeSH primário: Fármacos Cardiovasculares/administração & dosagem
Doenças Cardiovasculares/tratamento farmacológico
Óxidos de Nitrogênio/administração & dosagem
Nitroglicerina/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Fármacos Cardiovasculares/metabolismo
Doenças Cardiovasculares/metabolismo
Doenças Cardiovasculares/patologia
Vias de Administração de Medicamentos
Seres Humanos
Óxidos de Nitrogênio/metabolismo
Nitroglicerina/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cardiovascular Agents); 0 (Nitrogen Oxides); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171117
[Lr] Data última revisão:
171117
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171104
[St] Status:MEDLINE


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[PMID]:28877318
[Au] Autor:Wang NK; Fu Y; Wang JP; Kang EY; Wu AL; Tseng YJ; Yeh LK; Chen KJ; Wu WC; Ho WJ; Lai CC
[Ad] Endereço:Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
[Ti] Título:Peripheral Vascular Endothelial Dysfunction in Central Serous Chorioretinopathy.
[So] Source:Invest Ophthalmol Vis Sci;58(11):4524-4529, 2017 Sep 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: To explore the pathophysiology of central serous chorioretinopathy (CSC) by comparing peripheral vascular endothelium function in patients with CSC and control subjects. Methods: This study included 34 patients with CSC who attended the Department of Ophthalmology and 34 healthy age- and sex-matched healthy control subjects from a routine physical check-up population. Endothelium-dependent flow-mediated vasodilation (FMD) and endothelium-independent nitroglycerine-mediated vasodilation (NMD) were measured using high-resolution, two-dimensional ultrasonographic imaging of the brachial artery. Blood samples were taken to test serum glucose, cholesterol, triglyceride, alanine aminotransferase, uric acid, and high-sensitivity C-reactive protein (hs-CRP) levels. Results: The mean age of patients with CSC was 44.0 years (SD ±8.1) and that of controls 46.1 years (±9.9) (P = 0.352). There were no significant differences between groups in serum biochemical data, including serum glucose, alanine aminotransferase, uric acid, cholesterol, triglyceride, and hs-CRP. FMD was significantly impaired in patients with CSC compared with control subjects (CSC: 4.62 ± 1.96, control: 7.52 ± 2.63, P < 0.001), whereas NMD did not differ significantly between the two groups (CSC: 16.31 ± 5.60, control: 16.22 ± 5.56, P = 0.950). Conclusions: This study demonstrated impaired FMD in patients with CSC and the results have provided evidence of peripheral endothelium dysfunction associated with CSC in patients.
[Mh] Termos MeSH primário: Coriorretinopatia Serosa Central/fisiopatologia
Endotélio Vascular/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Velocidade do Fluxo Sanguíneo/fisiologia
Pressão Sanguínea
Artéria Braquial/diagnóstico por imagem
Artéria Braquial/fisiopatologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Nitroglicerina/farmacologia
Fluxo Sanguíneo Regional/fisiologia
Ultrassonografia
Vasodilatação/efeitos dos fármacos
Vasodilatação/fisiologia
Vasodilatadores/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasodilator Agents); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21825


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[PMID]:28692363
[Au] Autor:Patel P; Yau C; Kurian J
[Ad] Endereço:Cardiology Registrar and Clinical Research Fellow, Department of Cardiology, Leeds General Infirmary, Leeds LS1 3EX.
[Ti] Título:ST elevation myocardial infarction after coronary artery spasm with no clear trigger.
[So] Source:Br J Hosp Med (Lond);78(7):412-413, 2017 Jul 02.
[Is] ISSN:1750-8460
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Arritmias Cardíacas/etiologia
Vasoespasmo Coronário/complicações
Infarto do Miocárdio com Supradesnível do Segmento ST/etiologia
[Mh] Termos MeSH secundário: Anlodipino/uso terapêutico
Arritmias Cardíacas/terapia
Reanimação Cardiopulmonar
Angiografia Coronária
Vasoespasmo Coronário/diagnóstico
Vasoespasmo Coronário/tratamento farmacológico
Morte Súbita Cardíaca/prevenção & controle
Desfibriladores Implantáveis
Eletrocardiografia
Seres Humanos
Dinitrato de Isossorbida/análogos & derivados
Dinitrato de Isossorbida/uso terapêutico
Masculino
Meia-Idade
Nitroglicerina/uso terapêutico
Recidiva
Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico
Vasodilatadores/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasodilator Agents); 1J444QC288 (Amlodipine); G59M7S0WS3 (Nitroglycerin); IA7306519N (Isosorbide Dinitrate); LX1OH63030 (isosorbide-5-mononitrate)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.12968/hmed.2017.78.7.412


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[PMID]:28636863
[Au] Autor:Kondo T; Terada K
[Ad] Endereço:Chiba University Hospital, Chiba, Japan reds_liverpool_2005@yahoo.co.jp.
[Ti] Título:Coronary-Artery Vasospasm.
[So] Source:N Engl J Med;376(25):e52, 2017 Jun 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Vasoespasmo Coronário/diagnóstico por imagem
[Mh] Termos MeSH secundário: Dor no Peito/etiologia
Angiografia Coronária
Vasoespasmo Coronário/complicações
Vasoespasmo Coronário/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
Nitroglicerina/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMicm1614640


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[PMID]:28617840
[Au] Autor:Kim TH; Jang HJ; Kim S; Cho SY; Song KS; Pickett C; Schmitt HJ; Lee J
[Ad] Endereço:University of Connecticut Health Science Center, Farmington, Connecticut, United States of America.
[Ti] Título:A new test for diagnosing vasovagal syncope: Standing after treadmill test with sublingual nitrate administration.
[So] Source:PLoS One;12(6):e0179631, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Increased adrenergic tone might be an additional trigger of orthostatic stress of vasovagal syncope (VVS). Exercise before standing might provide increased sensitivity compared to standing using a sublingual nitroglycerines protocol during tilt table testing. The aim of this study was to evaluate the diagnostic value of treadmill testing before standing with nitroglycerin administration. METHODS AND RESULTS: A total of 36 patients with syncope or presyncope were enrolled for the test. VVS was confirmed in 29 patients according to the Calgary Score (≥ -2), including 20 patients who were likely to have typical (classical) VVS. All 36 subjects were subjected to a novel provocation test consisting of treadmill test using the Bruce protocol followed by standing with administration of 300 µg sublingual nitroglycerin. Consequently, syncope or presyncope occurred in 22 patients of the 36 patients. The sensitivity and a specificity of the test for Calgary score based VVS was 82.7% and 85.75%, respectively. Reproducibility rate for typical VVS was 90% (18 of 20). In all symptomatic patients, systolic blood pressure dropped to < 90 mmHg and symptom occurred a mean of 6.7 ± 2.3 minutes after the nitroglycerine administration. No patient required anticholinergics injection to restore vital signs. CONCLUSIONS: Treadmill test with administration of sublingual nitroglycerines might be safely used to reproduce syncope in patients with VVS. More clinical experience and confirmation are needed to validate this protocol.
[Mh] Termos MeSH primário: Teste de Esforço
Nitroglicerina/efeitos adversos
Síncope Vasovagal/diagnóstico
Síncope Vasovagal/fisiopatologia
[Mh] Termos MeSH secundário: Administração Sublingual
Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Nitroglicerina/administração & dosagem
Síncope Vasovagal/induzido quimicamente
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179631


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[PMID]:28488307
[Au] Autor:Sun YY; Zhang WJ; Dong CL; Zhang XF; Ji J; Wang X; Wang L; Hu WL; Du WJ; Cui CL; Zhang CF; Li F; Wang CZ; Yuan CS
[Ad] Endereço:State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, JS, 210009, China.
[Ti] Título:Baicalin Alleviates Nitroglycerin-induced Migraine in Rats via the Trigeminovascular System.
[So] Source:Phytother Res;31(6):899-905, 2017 Jun.
[Is] ISSN:1099-1573
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Migraine is a common neurological disorder with a serious impact on quality of life. The aim of this study was to explore the effect of baicalin on nitroglycerin-induced migraine rats. We carried out a behavioral research within 2 h post-nitroglycerin injection, and blood samples were drawn for measurements of nitric oxide (NO), calcitonin gene-related peptide, and endothelin (ET) levels. Immunohistochemistry was adopted to detect the activation of C-fos immunoreactive neurons in periaqueductal gray. The number, area size, and integrated optical density of C-fos positive cells were measured using Image-Pro Plus. As a result, baicalin administration (0.22 mm/kg) alleviated pain responses of migraine rats. It profoundly decreased NO and calcitonin gene-related peptide levels, increased ET levels, and rebuilt the NO/ET balance in migraine rats. Besides, baicalin pretreatment significantly reduced the number, the stained area size, and integrated optical density value of C-fos positive cells. In brief, this paper supports the possibility of baicalin as a potential migraine pharmacotherapy. Copyright © 2017 John Wiley & Sons, Ltd.
[Mh] Termos MeSH primário: Flavonoides/farmacologia
Transtornos de Enxaqueca/tratamento farmacológico
Nitroglicerina/efeitos adversos
Núcleo Inferior Caudal do Nervo Trigêmeo/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Peptídeo Relacionado com Gene de Calcitonina/metabolismo
Endotelinas/metabolismo
Feminino
Masculino
Transtornos de Enxaqueca/induzido quimicamente
Neurônios/efeitos dos fármacos
Óxido Nítrico/metabolismo
Proteínas Proto-Oncogênicas c-fos/metabolismo
Ratos
Ratos Sprague-Dawley
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Endothelins); 0 (Flavonoids); 0 (Proto-Oncogene Proteins c-fos); 31C4KY9ESH (Nitric Oxide); 347Q89U4M5 (baicalin); 83652-28-2 (Calcitonin Gene-Related Peptide); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE
[do] DOI:10.1002/ptr.5811


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[PMID]:28441653
[Au] Autor:Truse R; Hinterberg J; Schulz J; Herminghaus A; Weber A; Mettler-Altmann T; Bauer I; Picker O; Vollmer C
[Ad] Endereço:Department of Anesthesiology, Düsseldorf University Hospital, Düsseldorf, Germany.
[Ti] Título:Effect of Topical Iloprost and Nitroglycerin on Gastric Microcirculation and Barrier Function during Hemorrhagic Shock in Dogs.
[So] Source:J Vasc Res;54(2):109-121, 2017.
[Is] ISSN:1423-0135
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Topical drug application is used to avoid systemic side effects. The aim of this study was to analyze whether locally applied iloprost or nitroglycerin influence gastric mucosal perfusion, oxygenation, and barrier function during physiological and hemorrhagic conditions. METHODS: In repeated experiments, 5 anesthetized dogs received iloprost, nitroglycerin, or normal saline during physiological and hemorrhagic (-20% blood volume) conditions. Macro- and microcirculatory variables were recorded continuously. Gastric barrier function was assessed via translocation of sucrose into the blood. RESULTS: During hemorrhage, gastric mucosal oxygenation decreased from 77 ± 4 to 37 ± 7%. This effect was attenuated by nitroglycerin (78 ± 6 to 47 ± 13%) and iloprost (82 ± 4 to 54 ± 9%). Sucrose plasma levels increased during hemorrhage from 7 ± 4 to 55 ± 15 relative amounts. This was alleviated by nitroglycerin (5 ± 8 to 29 ± 38 relative amounts). These effects were independent of systemic hemodynamic variables. CONCLUSIONS: During hemorrhage, topical nitroglycerin and iloprost improve regional gastric oxygenation without affecting perfusion. Nitroglycerin attenuated the shock-induced impairment of the mucosal barrier integrity. Thus, local drug application improves gastric microcirculation without compromising systemic hemodynamic variables, and it may also protect mucosal barrier function.
[Mh] Termos MeSH primário: Absorção Gástrica/efeitos dos fármacos
Mucosa Gástrica/efeitos dos fármacos
Iloprosta/administração & dosagem
Microcirculação/efeitos dos fármacos
Nitroglicerina/administração & dosagem
Choque Hemorrágico/tratamento farmacológico
Vasodilatadores/administração & dosagem
[Mh] Termos MeSH secundário: Administração Tópica
Animais
Modelos Animais de Doenças
Cães
Feminino
Mucosa Gástrica/irrigação sanguínea
Mucosa Gástrica/metabolismo
Oxigênio/sangue
Oxiemoglobinas/metabolismo
Permeabilidade
Choque Hemorrágico/sangue
Choque Hemorrágico/fisiopatologia
Sacarose/sangue
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Oxyhemoglobins); 0 (Vasodilator Agents); 57-50-1 (Sucrose); G59M7S0WS3 (Nitroglycerin); JED5K35YGL (Iloprost); S88TT14065 (Oxygen)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE
[do] DOI:10.1159/000464262


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[PMID]:28429459
[Au] Autor:Bath PM; Krishnan K; Appleton JP
[Ad] Endereço:Stroke, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Nottingham, UK, NG5 1PB.
[Ti] Título:Nitric oxide donors (nitrates), L-arginine, or nitric oxide synthase inhibitors for acute stroke.
[So] Source:Cochrane Database Syst Rev;4:CD000398, 2017 04 21.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nitric oxide (NO) has multiple effects that may be beneficial in acute stroke, including lowering blood pressure, and promoting reperfusion and cytoprotection. Some forms of nitric oxide synthase inhibition (NOS-I) may also be beneficial. However, high concentrations of NO are likely to be toxic to brain tissue. This is an update of a Cochrane review first published in 1998, and last updated in 2002. OBJECTIVES: To assess the safety and efficacy of NO donors, L-arginine, and NOS-I in people with acute stroke. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (last searched 6 February 2017), MEDLINE (1966 to June 2016), Embase (1980 to June 2016), ISI Science Citation Indexes (1981 to June 2016), Stroke Trials Registry (searched June 2016), International Standard Randomised Controlled Trial Number (ISRCTN) (searched June 2016), Clinical Trials registry (searched June 2016), and International Clinical Trials Registry Platform (ICTRP) (searched June 2016). Previously, we had contacted drug companies and researchers in the field. SELECTION CRITERIA: Randomised controlled trials comparing nitric oxide donors, L-arginine, or NOS-I versus placebo or open control in people within one week of onset of confirmed stroke. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the inclusion criteria, assessed trial quality and risk of bias, and extracted data. The review authors cross-checked data and resolved issues through discussion. We obtained published and unpublished data, as available. Data were reported as mean difference (MD) or odds ratio (OR) with 95% confidence intervals (CI). MAIN RESULTS: We included five completed trials, involving 4197 participants; all tested transdermal glyceryl trinitrate (GTN), an NO donor. The assessed risk of bias was low across the included studies; one study was double-blind, one open-label and three were single-blind. All included studies had blinded outcome assessment. Overall, GTN did not improve the primary outcome of death or dependency at the end of trial (modified Rankin Scale (mRS) > 2, OR 0.97, 95% CI 0.86 to 1.10, 4195 participants, high-quality evidence). GTN did not improve secondary outcomes, including death (OR 0.78, 95% CI 0.40 to 1.50) and quality of life (MD -0.01, 95% CI -0.17 to 0.15) at the end of trial overall (high-quality evidence). Systolic/diastolic blood pressure (BP) was lower in people treated with GTN (MD -7.2 mmHg (95% CI -8.6 to -5.9) and MD -3.3 (95% CI -4.2 to -2.5) respectively) and heart rate was higher (MD 2.0 beats per minute (95% CI 1.1 to 2.9)). Headache was more common in those randomised to GTN (OR 2.37, 95% CI 1.55 to 3.62). We did not find any trials assessing other nitrates, L-arginine, or NOS-I. AUTHORS' CONCLUSIONS: There is currently insufficient evidence to recommend the use of NO donors, L-arginine or NOS-I in acute stroke, and only one drug (GTN) has been assessed. In people with acute stroke, GTN reduces blood pressure, increases heart rate and headache, but does not alter clinical outcome (all based on high-quality evidence).
[Mh] Termos MeSH primário: Arginina/uso terapêutico
Inibidores Enzimáticos/uso terapêutico
Doadores de Óxido Nítrico/uso terapêutico
Óxido Nítrico Sintase/antagonistas & inibidores
Nitroglicerina/uso terapêutico
Acidente Vascular Cerebral/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Isquemia Encefálica/tratamento farmacológico
Cefaleia/induzido quimicamente
Seres Humanos
Doadores de Óxido Nítrico/efeitos adversos
Nitroglicerina/efeitos adversos
Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Acidente Vascular Cerebral/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Enzyme Inhibitors); 0 (Nitric Oxide Donors); 94ZLA3W45F (Arginine); EC 1.14.13.39 (Nitric Oxide Synthase); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD000398.pub2


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[PMID]:28427595
[Au] Autor:Dudek D; Rzeszutko L; Onuma Y; Sotomi Y; Depukat R; Veldhof S; Ediebah D; Staehr P; Zasada W; Malinowski KP; Kaluza GL; Serruys PW
[Ad] Endereço:Jagiellonian University Institute of Cardiology, Krakow, Poland. Electronic address: mcdudek@cyfronet.pl.
[Ti] Título:Vasomotor Response to Nitroglycerine Over 5 Years Follow-Up After Everolimus-Eluting Bioresorbable Scaffold Implantation.
[So] Source:JACC Cardiovasc Interv;10(8):786-795, 2017 Apr 24.
[Is] ISSN:1876-7605
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study investigated the vasomotor response to nitroglycerine (NTG) up to 5 years after ABSORB implantation. BACKGROUND: There are no data regarding long-term vasomotor response after everolimus-eluting bioresorbable vascular scaffold ABSORB implantation. METHODS: We performed quantitative coronary angiography of the scaffolded and proximal and distal adjacent segments of patients from ABSORB Cohort B study before and after 200 µg of intracoronary NTG at 2, 3, and 5 years of follow-up. The mean changes of maximal and mean lumen diameters in the scaffolded and adjacent segments were calculated. RESULTS: The mean in-scaffold lumen diameter change in response to NTG showed a trend to increase over time with absolute values of 0.03 ± 0.09 mm, 0.05 ± 0.12 mm, and 0.07 ± 0.08 mm at 2, 3, and 5 years, respectively (p = 0.40). The maximal in-scaffold lumen diameter change significantly increased with values of 0.03 ± 0.14 mm, 0.06 ± 0.16 mm, and 0.11 ± 0.1 mm at 2, 3, and 5 years, respectively (p = 0.03). The normalized mean lumen diameter change after NTG in the scaffold relative to the adjacent segments was 51.9 ± 54.8% at 5 years of follow-up (p = 0.60). CONCLUSIONS: Although there was a numerical increase of the vasomotor response to NTG after ABSORB implantation measured by quantitative coronary angiography with mean lumen diameter, the change was not statistically significant. However, the maximal lumen diameter changes increased over time from 2 to 5 years and attained statistical significance. The vasomotor response to NTG after ABSORB implantation moderately trended to increase, which is consistent with the progressive degradation and bioresorption of the scaffold, but the degree of vasomotor response remained lower in comparison with adjacent segments.
[Mh] Termos MeSH primário: Implantes Absorvíveis
Fármacos Cardiovasculares/administração & dosagem
Materiais Revestidos Biocompatíveis
Doença da Artéria Coronariana/terapia
Vasos Coronários/efeitos dos fármacos
Everolimo/administração & dosagem
Nitroglicerina/administração & dosagem
Intervenção Coronária Percutânea/instrumentação
Vasodilatação/efeitos dos fármacos
Vasodilatadores/administração & dosagem
Sistema Vasomotor/efeitos dos fármacos
[Mh] Termos MeSH secundário: Fármacos Cardiovasculares/efeitos adversos
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico por imagem
Doença da Artéria Coronariana/fisiopatologia
Vasos Coronários/diagnóstico por imagem
Vasos Coronários/fisiopatologia
Everolimo/efeitos adversos
Seres Humanos
Intervenção Coronária Percutânea/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
Ultrassonografia de Intervenção
Vasoconstrição/efeitos dos fármacos
Sistema Vasomotor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Cardiovascular Agents); 0 (Coated Materials, Biocompatible); 0 (Vasodilator Agents); 9HW64Q8G6G (Everolimus); G59M7S0WS3 (Nitroglycerin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE



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