Systematic Review

Therapeutic and safety outcomes of intracoronary nicardipine in coronary artery disease patients: a systematic review

https://orcid.org/0000-0001-6724-2360

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Laiba Imran

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Aqsa Salim

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Syed Owais Javed

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Aruba Sohail

https://orcid.org/0000-0002-9869-0921

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Hassan ul Hussain

https://orcid.org/0000-0002-0464-0887

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Jawad Ahmed

https://orcid.org/0000-0001-5651-1916

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Farah Yasmin

https://orcid.org/0000-0002-5264-6140

Department of Internal Medicine, Dow University of Health Sciences, Karachi, 74200, Pakistan

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Md. Saiful Islam

Department of Public Health & Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh

Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, 1342, Bangladesh

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Muhammad Sohaib Asghar

*Author for correspondence:

E-mail Address: sohaib_asghar123@yahoo.com

https://orcid.org/0000-0001-6705-2030

Division of Nephrology & Hypertension, Mayo Clinic, Rochester, US 55905, USA

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Published Online:2 Jun 2023https://doi.org/10.2217/fca-2022-0085

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Abstract

Aim: This systematic review aimed to shed light on the efficacy of intracoronary (IC) nicardipine in treating no reflow with CAD undergoing revascularization. Methods: Literature search was performed on databases with following eligibility criteria: adult patients with CAD; clinical trials or observational studies; IC nicardipine as intervention; therapeutic and safety outcome reported. Results: A total of 1249 papers were yielded during the literature search. Of these, 11 studies were finalized for this systematic review. Complete restoration of TIMI 3 flow was observed in 98.6% of the patients receiving IC nicardipine. A significant increase in the CBF after infusion of IC nicardipine (p < 0.05) was also observed. Conclusion: IC nicardipine significantly increases CBF and decreases coronary vascular resistance.

Plain language summary

Coronary artery disease (CAD) is a condition that results in the narrowing or blockage of heart arteries. Arteries are blood vessels that bring oxygen-rich blood from your heart to the rest of your body's cells. We aimed to evaluate the effects of intracoronary (IC) nicardipine, a drug that blocks calcium from entering the muscle cells and blood vessels of the heart, which causes the vessels to relax and widen, allowing for blood to flow more easily, on a phenomenon known as coronary slow flow (CSF). CSF is defined as a delayed widening of the blood vessels of the heart. CSF or the no reflow phenomenon is a major negative complication associated with surgical procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), both of which are used to open up blocked arteries. The systematic search identified studies that evaluated the effect of IC nicardipine in patient during CAD treatment, undergoing PCI, CABG, or having confirmed or suspected narrowing of the aortic valve or one of the four valves of the heart, which results in restricted blood flow from the heart to the body. From the results of studies discussed in the review, it can be concluded that IC nicardipine significantly increases blood flow to the heart and can help prevent the no reflow phenomenon in patients undergoing PCI. Nicardipine proved to be a safe and effective option in the management of complications such as no reflow in patients receiving therapies to restore blood flow following CAD.

Keywords:

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Vol. 19, No. 3

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History

Received 7 September 2022

Accepted 17 April 2023

Published online 2 June 2023

Published in print March 2023

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Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fca-2022-0085

Author contributions

Conceptualization: ST Rehan. Methodology: Aruba Sohail (ASo), ST Rehan. Writing – original draft: ST Rehan, L Imran, A Salim (ASa), SO Javed, H Hussain, A Sohail, J Ahmed. Writing – review & editing: J Ahmed, ST Rehan, H Hussain. Project administration: ST Rehan, J Ahmed, MS Asghar. Guarantor: F Yasmin, MS Asghar. All authors have read and approved the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

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