Skip to main content

Calcium Antagonists in Patients Undergoing Coronary Artery Bypass Surgery

  • Chapter
Coronary Artery Graft Disease

Abstract

Calcium antagonists have demonstrated efficacy in cardiovascular medicine with clear antihypertensive, antiarrhythmic, and anti-ischemic properties. Due to the widespread use of calcium antagonists for patients with hypertension, arrhythmias, and ischemic heart disease, many patients who are undergoing coronary bypass surgery are often taking these medications. There are also several potential indications to initiate calcium antagonist therapy before, during, or after coronary bypass surgery and these will be addressed in this chapter under the following subheadings:

  1. 1.

    Antihypertensive therapy

  2. 2.

    Anti-arrhythmic therapy

  3. 3.

    Anti-ischemic therapy

  4. 4.

    Anti-atherosclerotic therapy

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Boylan JF, O’Leary G, Weisel RD et al (1990) A comparison of diltiazem, esmolol, nifedipine and nitroprusside therapy of post-CABG hypertension. Can J Anesth 6: S156 (abstract).

    Google Scholar 

  2. Lawrence CJ, Lestrade A, deLange S (1991) Isradipine, a calcium antagonist, in the control of hypertension following coronary artery-bypass surgery. Am J Hypertens 4: 207S–209S.

    PubMed  CAS  Google Scholar 

  3. Brister NW, Barnette RE, Schartel SA et al (1991) Isradipine for treatment of acute hypertension after myocardial revascularization. Grit Care Med 19: 334–338.

    Article  CAS  Google Scholar 

  4. Underwood SM, Feneck RO, Davies SW et al (1989) Use of isradipine in hypertension following coronary artery bypass surgery. Am J Med 86: 81–87.

    Article  PubMed  CAS  Google Scholar 

  5. Colson P, Medioni P, Saussine M et al (1992) Hemodynamic effect of calcium channel blockade during anesthesia for coronary artery surgery. J Cardiothorac Anesth 6: 424–4428.

    Article  CAS  Google Scholar 

  6. Hicks GL, Salley RK, DeWeese JA (1984) Calcium channel blockers: an intraoperative and postoperative trial in women. Ann Thorac Surg 37: 319–322.

    Article  PubMed  Google Scholar 

  7. Ferraris VA, Ferraris SP, Gilliam HS et al (1991) Predictors of postoperative ventricular dysrhythmias: a multivariate study. J Cardiovasc Surg 32: 12–20.

    CAS  Google Scholar 

  8. Gottlieb SO, Ouyang P, Achuff SC et al (1984) Acute nifedipine withdrawal: Consequences of preoperative and late cessation of therapy in patients with prior unstable angina. J Am Coll Cardiol 4: 382–388.

    Article  PubMed  CAS  Google Scholar 

  9. Colson P, Medioni P, Saussine M et al (1992) Hemodynamic effect of calcium channel blockade during anesthesia for coronary artery surgery. J Cardiothorac Vasc Anesth 6(4): 424–428.

    Article  PubMed  CAS  Google Scholar 

  10. Seitelberger R, Zwolfer W, Huber S et al (1991) Nifedipine reduces the incidence of myocardial infarction and transient ischemia in patients undergoing coronary bypass grafting. Circulation 83: 460–468.

    PubMed  CAS  Google Scholar 

  11. Seitelberger R, Zwolfer W, Binder TM (1990) Infusion of nifedipine following coronary artery bypass grafting decreases the incidence of early postoperative myocardial ischemia. Ann Thorac Surg 49: 61–68.

    Article  PubMed  CAS  Google Scholar 

  12. Myles PS, Olenikov I, Bujor MA et al (1993) ACE-inhibitors, calcium antagonists and low systemic vascular resistance following cardiopulmonary bypass. A case-control study. Med J Aust 158: 675–677.

    PubMed  CAS  Google Scholar 

  13. Becker RC, Alpert JS (1990) The impact of medical therapy on hemorrhagic complications following coronary artery bypass grafting. Arch Int Med 150: 2016–2021.

    Article  CAS  Google Scholar 

  14. Henry PD, Bentley KI (1981) Suppression of atherogenesis in cholesterol-fed rabbit treated with nifedipine. J Clin Invest 68: 1366–1369.

    Article  PubMed  CAS  Google Scholar 

  15. Henry PD (1990) Anti-atherogenic effects of calcium channel blockers: possible mechanisms of action. Cardiovasc Drugs Ther 4: 1015–1020.

    Article  PubMed  Google Scholar 

  16. Weinstein DB, Helder JG (1987) Antiatherogenic properties of calcium antagonists. Am J Cardiol 59: 163B–172B.

    Article  PubMed  CAS  Google Scholar 

  17. Henry P (1990) Calcium antagonists as anti-atherosclerotic agents. Arteriosclerosis 10: 963–965.

    Article  PubMed  CAS  Google Scholar 

  18. Kober G, Schneider W, Kaltenbach M (1989) Can the progression of coronary sclerosis be influenced by calcium antagonists? J Cardiovasc Pharmacol 13: S2–S6.

    Article  PubMed  Google Scholar 

  19. Holzgreve H, Burkle B (1993) Anti-atherosclerotic effects of calcium antagonists. J Hypertens 11: 555–559.

    Article  Google Scholar 

  20. Ginsburg R, Davis K, Bristow MR et al (1983) Calcium antagonists suppress atherogenesis in aorta but not in the intramural coronary arteris of cholesterol-fed rabbits. Lab Invest 49: 154–158.

    PubMed  CAS  Google Scholar 

  21. Rouleau JL, Parmley WW, Stevens J et al (1983) Verapamil suppresses atherosclerosis in cholesterol-fed rabbits. J Am Coll Cardiol 1: 1453–1460.

    Article  PubMed  CAS  Google Scholar 

  22. Willis AL, Nagel B, Churchill V et al (1985) Antiatherosclerotic effects of nicardipine and nifedipine in cholesterol-fed rabbits. Arteriosclerosis 5: 250–255.

    Article  PubMed  CAS  Google Scholar 

  23. Parmley WW (1990) Vascular protection from atherosclerosis: potential of calcium antagonists. Am J Cardiol 66: 161–221.

    Google Scholar 

  24. Nayler WG, Panagiotopoulos S (1993) The antiatherosclerotic effect of the calcium antagonists and their implications in hypertension. Am Heart J 125: 626–629.

    Article  PubMed  CAS  Google Scholar 

  25. Vos J, DeFeyter PJ, Simoons ML et al (1993) Retardation and arrest of progression or regression of coronary artery disease: a review. Prog Cardiovasc Dis 35: 435–454.

    Article  PubMed  CAS  Google Scholar 

  26. Triggle DJ (1992) Calcium-channel antagonists: mechanisms of action, vascular selectivities, and clinical relevance. Cleve Clin J Med 59: 617–627.

    PubMed  CAS  Google Scholar 

  27. Waters D, Lesperance J, Francetich M et al (1990) A controlled clinical trial to assess the effect of a calcium channel blocker on the progression of coronary atherosclerosis. Circ 82: 1940–1953.

    Article  CAS  Google Scholar 

  28. Loaldi A, Polese A, Montorsi P et al (1989) Comparison of nifedipine, propranolol and isosorbide dinitrate on angiographic progressoin and regression of coronary arterial narrowings in angina pectoris. Am J Cardiol 64: 433–439.

    Article  PubMed  CAS  Google Scholar 

  29. Gottlieb SO, Brinker JA, Mellits ED et al (1989) Effect of nifedipine on the development of coronary bypass graft stenoses in high-risk patients: a randomized, double-blind, placebo-controlled trial. Circulation 80: 11228 (abstract).

    Google Scholar 

  30. Borhani NO, Brugger SB, Byington RP (1990) Multicenter study with isradipine and diuretics against atherosclerosis. J Cardiovasc Pharmacol 15: S23–S29.

    PubMed  Google Scholar 

  31. Lichtlen PR, Hugenholtz PG, Rafflenbeul W et al (1990) Retardation of angiographic progression of coronary artery disease by nifedipine. Lancet 335: 1109–1113.

    Article  PubMed  CAS  Google Scholar 

  32. Unni KK, Kottke BA, Titus JL et al (1974) Pathologic changes in aortocoronary saphenous vein grafts. Am J Cardiol 34: 526–532.

    Article  PubMed  CAS  Google Scholar 

  33. Campeau L, Enjalbert M, Lesperance J et al (1984) Risk factors relative to atherosclerosis in saphenous vein bypass grafts and native vessels: a 10-year followup study. N Engl J Med 311: 1329–1332.

    Article  PubMed  CAS  Google Scholar 

  34. Blankenhorn DH, Nessim SA, Johnson RL et al (1987) Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. JAMA 257: 3233–3240.

    Article  PubMed  CAS  Google Scholar 

  35. Chesebro JH, Fuster V, Elveback LR et al (1984) Effect of dipyridamole and aspirin on late vein-graft patency after coronary bypass operations. N Engl J Med 310: 209–214.

    Article  PubMed  CAS  Google Scholar 

  36. Brown BG, Cukingnan RA, DeRouen T et al (1985) Improved graft patency in patients treated with platelet-inhibiting therapy after coronary bypass surgery. Circulation 72: 138–146.

    Article  PubMed  CAS  Google Scholar 

  37. Chesebro JH, Webster MWI, Smith HC et al (1989) Antiplatelet therapy in coronary disease progression: reduced infarction and new lesion formation. Circulation 80: 11266 (abstract).

    Google Scholar 

  38. McCallister BD, Giorgi LV, Ligon R et al (1989) Effectiveness of aortocoronary bypass: a one year angiographic study using diltiazem and antiplatelet therapy. Circulation 80: II392.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Gottlieb, S.O. (1994). Calcium Antagonists in Patients Undergoing Coronary Artery Bypass Surgery. In: Lüscher, T.F., Turina, M., Braunwald, E. (eds) Coronary Artery Graft Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78637-2_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78637-2_19

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-78639-6

  • Online ISBN: 978-3-642-78637-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics