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(Circulation. 2001;104:I-64.)
© 2001 American Heart Association, Inc.

Surgery for Coronary Artery Disease

Clinical and Angiographic Effects of Chronic Calcium Channel Blocker Therapy Continued Beyond First Postoperative Year in Patients With Radial Artery Grafts

Results of a Prospective Randomized Investigation

Mario Gaudino, MD; Franco Glieca, MD; Nicola Luciani, MD; Francesco Alessandrini, MD; Gianfederico Possati, MD

Department of Cardiac Surgery, Catholic University, Rome, Italy.

Correspondence to Mario Gaudino, MD, Divisione di Cardiochirurgia, Policlinico Universitario A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy. E-mail mgaudino{at}tiscalinet.it

Background— This study was conceived to elucidate the clinical and angiographic effects of chronic calcium channel blocker therapy (CCCBT) continued after the first postoperative year in patients in whom the radial artery (RA) was used for myocardial revascularization.

Methods and Results— Patients who received RA grafts at our institution and who at 1 year had no scintigraphic evidence of ischemia in the RA territory or angiographic evidence of RA malfunction (n=120) were randomly assigned to continue (n=63) or suspend (n=57) the CCCBT with diltiazem (120 mg/d). After 5 years, all patients were reassessed clinically and by stress myocardial scintigraphy, and 87 of them (45 from the continued group that continued CCCBT and 42 from the group that suspended CCCBT) were restudied angiographically. No differences regarding either the clinical and scintigraphic results or the RA angiographic status were demonstrated between the 2 groups.

Conclusions— After the first postoperative year, the continuation of CCCBT does not affect RA graft patency or clinical and scintigraphic results.

Key Words: arteries • coronary disease • surgery