Comparison of the effects of nicorandil and cocktail solution to prevent radial artery spasm during coronary angiography

Background and Objectives: A radial artery spasm is one of the most common complications of coronary angiography during a transradial, causing considerable patient discomfort, which sometimes disturbs the procedure. This study was designed to evaluate the effects of nicorandil in the prevention of a radial artery spasm during coronary angiography. Subjects and Methods: This was a randomized study to compare 4 mg of nicorandil and a 10 mL cocktail solution performed in 100 patients. Vasospasms of the radial artery, which were expressed as stenosis of the vessel diameter with a transradial approach and radial artery patency by pulse oximetry analysis one month later, were examined. Results: Reductions in the systolic and diastolic blood pressures after administration of the spasmolytic agents were 15.8 ± 11.8/8.4 ± 8.0 and 20.5 ± 13.6/6.7 ± 6.2 in the for nicorandil and cocktail groups, respectively. Nicorandil induced a lesser decrease in the systolic BP than the cocktail, but without statistical significance (p = 0.07). Both vasodilating agents showed a significant radial artery vasodilation following their intra-arterial administration (p < 0.001 for all). The diameter of the radial artery showed a significant decrease in both groups following catheterization (p < 0.05 for all). There were no significant differences between the two groups in terms of radial artery spasms (46 vs. 58% in nicorandil and cocktail groups, respectively, p = 0.709). Conclusion: Nicorandil, with vasodilatory effects due to a dual mechanism was as effective as the cocktail solution in the vasodilation of the radial artery.