Perioperative diltiazem or nitroglycerin in on-pump coronary artery bypass: A systematic review and network meta-analysis

PloS One
Yirui HuXiaopeng Zhang

Abstract

Arterial graft spasm is a severe complication after coronary artery bypass graft (CABG). Among numerous potential antispasmodic agents, systemic application of diltiazem and nitroglycerin had been investigated most frequently over the past three decades. However, it remains inconclusive if either or both agents could improve patient outcomes by preventing graft spasm when applied perioperatively, and, if so, which one would be a better choice. The current systematic review and network meta-analysis aims to summarize the data from all available randomized clinical trials of perioperative continuous intravenous infusion of diltiazem and/or nitroglycerin in patients undergoing on-pump CABG in order to define and compare their roles in graft spasm prevention and their impacts on perioperative outcomes. We searched Ovid Medline, PubMed, CINAHL, Google Scholar and Cochrane Center for randomized controlled trials that reported outcome effects of perioperative continuous intravenous infusion of diltiazem and/or nitroglycerin in patients undergoing elective on-pump CABG. Conventional meta-analyses were conducted to evaluate the pairwise comparisons (diltiazem vs. placebo; nitroglycerin vs. placebo; diltiazem vs. nitroglycerin) on periop...Continue Reading

References

Aug 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·P ColsonB Roquefeuil
Jun 1, 1986·The Thoracic and Cardiovascular Surgeon·E DoneganiM Morea
Nov 1, 1989·European Heart Journal·H SievertW D Bussmann
Jun 1, 1986·Anesthesiology·J D GallagherD L Clark
Aug 1, 1987·The Annals of Thoracic Surgery·M R SarabuG E Reed
Dec 1, 1993·Journal of Cardiothoracic and Vascular Anesthesia·G ZanardoG Simini
Jan 1, 1993·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·W HannesR Seitelberger
Jan 1, 1995·Journal of Cardiovascular Pharmacology·T HaakK H Usadel
Jan 1, 1996·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·J Babin-EbellO Elert
Dec 1, 1996·The Annals of Thoracic Surgery·D ArnaudovS Ezra
Jan 1, 1997·The Journal of Thoracic and Cardiovascular Surgery·J J LiuB F Buxton
Oct 23, 1997·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·R MalhotraN Trehan
Oct 23, 1998·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·V L SerebruanyP A Gurbel
Apr 10, 1999·The Annals of Thoracic Surgery·I A ApostolidouD G Lappas
Aug 2, 2000·The Annals of Thoracic Surgery·D AbramovB S Goldman
Oct 4, 2000·The Annals of Thoracic Surgery·O M ShapiraR J Shemin
Dec 8, 2000·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·J Fragata
Feb 24, 2001·The Annals of Thoracic Surgery·D ZabeedaA J Cohen
Aug 23, 2001·The Annals of Thoracic Surgery·J Chanda, C C Canver
Jun 13, 2002·Proceedings of the National Academy of Sciences of the United States of America·Louis J Ignarro
Oct 29, 2002·The Annals of Thoracic Surgery·C LockerI Shapira
May 14, 2003·Journal of the American College of Cardiology·Duminda N WijeysunderaJacek Karski
Mar 24, 2004·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Yildiray TabelOzgür Aslan
Apr 1, 2005·The Heart Surgery Forum·Hafize YalinizCumhur Alhan
Apr 10, 2010·Journal of Neuroradiology. Journal De Neuroradiologie·S KremerF Schneider
Feb 12, 2011·The Journal of International Medical Research·T EgeE Duran
Oct 13, 2011·Journal of Neurointerventional Surgery·UNKNOWN American College of Cardiology Foundation/American Heart Association Task ForceAllen J Taylor
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
May 24, 2013·Korean journal of urology·Jae Hoon Chung, Seung Wook Lee
Jan 16, 2014·Multimedia Manual of Cardiothoracic Surgery : MMCTS·James Tatoulis
Jan 9, 2015·Journal of Cardiothoracic Surgery·Jeffrey LeJean-Francois Legare
Jul 16, 2015·The New England Journal of Medicine·Benjamin S SteinhornThomas Michel

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Citations

Jul 3, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Giancarlo PirozzoloPeter Ong
Jul 7, 2021·Mayo Clinic Proceedings·Ravindra GaneshKaren F Mauck

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

Ovid Medline
Stata
Cochrane
Google Scholar

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