European Radiology

, 19:2931

“In-house” pharmacological management for computed tomography coronary angiography: heart rate reduction, timing and safety of different drugs used during patient preparation

  • Erica Maffei
  • Alessandro A. Palumbo
  • Chiara Martini
  • Carlo Tedeschi
  • Giuseppe Tarantini
  • Sara Seitun
  • Livia Ruffini
  • Annachiara Aldrovandi
  • Annick C. Weustink
  • Willem B. Meijboom
  • Nico R. Mollet
  • Gabriel P. Krestin
  • Pim J. de Feyter
  • Filippo Cademartiri
Cardiac

DOI: 10.1007/s00330-009-1509-0

Cite this article as:
Maffei, E., Palumbo, A.A., Martini, C. et al. Eur Radiol (2009) 19: 2931. doi:10.1007/s00330-009-1509-0

Abstract

We retrospectively evaluated the effect, timing and safety of different pharmacological strategies during 64-slice CT coronary angiography (CT-CA). From the institutional database of CT-CA we enrolled 560 consecutive patients with suspected coronary artery disease. The type of drug preparation (group 1 = no treatment; group 2 = oral metoprolol; group 3 = other; group 4 = intravenous (IV) atenolol; group 5 = IV atenolol + nitrates; NR = non-responders), timing, and adverse effects were recorded. Heart rate (HR) during different preparation phases was recorded. Four adverse effects were recorded, none of which was attributable to pharmacological treatment. In all groups, except group 1, the HR on arrival was significantly reduced by the pharmacological treatment (p < 0.01). Group 4 showed the best (−16 ± 8 bpm) HR reduction. There was no significant effect on HR due to nitrates (p = 0.49), while a slight increase due to contrast material was noted (p < 0.05). Average time required for preparation was 44 ± 25 min. Groups 4 and 5 showed the most effective timing (8 ± 9 min and 8 ± 8 min, respectively; p < 0.01). Pharmacological preparation in patients undergoing CT-CA is safe and effective. Best results in terms of HR reduction and fast preparation are obtained with IV administration of beta-blockers.

Keywords

DrugBeta-blockersHeart rateMultislice computed tomographyCoronary artery disease64-slice CTIntravenous

Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Erica Maffei
    • 1
  • Alessandro A. Palumbo
    • 1
    • 2
  • Chiara Martini
    • 1
    • 2
  • Carlo Tedeschi
    • 1
  • Giuseppe Tarantini
    • 1
    • 4
  • Sara Seitun
    • 1
  • Livia Ruffini
    • 1
  • Annachiara Aldrovandi
    • 1
  • Annick C. Weustink
    • 2
  • Willem B. Meijboom
    • 2
  • Nico R. Mollet
    • 2
  • Gabriel P. Krestin
    • 2
  • Pim J. de Feyter
    • 2
  • Filippo Cademartiri
    • 1
    • 2
    • 3
  1. 1.Department of Radiology and CardiologyAzienda Ospedaliero - Universitaria di ParmaParmaItaly
  2. 2.Department of Radiology and CardiologyErasmus Medical CenterRotterdamThe Netherlands
  3. 3.Department of Radiology c/o Piastra Tecnica - Piano 0Azienda Ospedaliero-Universitaria - ParmaParmaItaly
  4. 4.Department of CardiologyUniversity of PaduaPaduaItaly