Pill or pump? Nitroglycerin 0.5 mg tablet vs 0.8 mg spray: Effect on proximal vessel diameters at Coronary CT Angiography (CCTA).

The administration of sublingual Nitroglycerin (NTG) prior to CT coronary angiography (CCTA) can be perfomed using pump spray or tablets. Choice of method seems to be based on local preference, rather than published guidelines. This retrospective analysis tested whether proximal coronary diameters d...

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Publicado en:Radiography Vol. 29; no. 5; pp. 918 - 926
Autores principales: Kusk, M.W., Bromark, C.S., Hestbek-Møller, M., Davidsen, L.Ø., Precht, H., Brage, K.
Formato: research tables/charts Journal Article
Publicado: W B Saunders Aug2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2023
      vid: 29
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      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        10.1016/j.radi.2023.07.004
        169929819
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        atl: Pill or pump? Nitroglycerin 0.5 mg tablet vs 0.8 mg spray: Effect on proximal vessel diameters at Coronary CT Angiography (CCTA).
      aug:
        au:
          Kusk, M.W.
          Bromark, C.S.
          Hestbek-Møller, M.
          Davidsen, L.Ø.
          Precht, H.
          Brage, K.
        affil: Imaging Research Initiative SouthWest (IRIS), Esbjerg, Denmark
      sug:
        subj:
          Coronary Vessels Radiography
          Multidetector Computed Tomography Methods
          Computed Tomography Angiography Methods
          Coronary Angiography Methods
          Coronary Vessels Physiology
          Nitroglycerin Administration and Dosage
          Vasodilator Agents
          Tablets
          Human
          Male
          Female
          Retrospective Design
          Analysis of Variance
          Intraclass Correlation Coefficient
          Descriptive Statistics
          Comparative Studies
          Administration, Sublingual
          Administration, Oral
          Male
          Female
      ab: The administration of sublingual Nitroglycerin (NTG) prior to CT coronary angiography (CCTA) can be perfomed using pump spray or tablets. Choice of method seems to be based on local preference, rather than published guidelines. This retrospective analysis tested whether proximal coronary diameters differed dependent on the sublingual administration of 0.5 mg Nitroglycerin (NTG) tablets or 0.8 mg NTG spray. 287 ECG-gated CCTA studies with optimal image quality and Agatston scores<400 were included in this retrospective analysis. 143 of the patients were dosed with NTG tablets at a dose of 0.5 mg prior to CCTA. 144 patients received 2 puffs of 0.4 mg NTG spray for a total dose of 8 mg. All were scanned on a second-generation Dual Source CT. Diameters of proximal segments of Left Main (LM), Right (RCA), Left Anterior (LAD) and circumflex (CX) coronary arteries were measured using semi-automatic electronic callipers by two blinded readers. Results were summarised as the mean of maximum and minimum diameters. Sex-specific analysis of diameters was carried out using repeated-measures ANOVA for each vessel. Agreement between readers was examined with Bland-Altman analysis and intra-class-correlation coefficient (ICC). No significant differences in coronary diameters were found except in the RCA for women and LM for men. In both cases, diameters were smaller in the spray group (11 and 9%, respectively). Reader agreement was excellent, with ICC>0.96 for all vessels, and no significant bias, except in CX (0.03 mm). We found no evidence for the systematic superiority of either administration method in proximal coronary vessels. Choosing between tablet or spray NTG prior to CCTA can be guided by practical, economical and hygienic considerations alone.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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