Abstract 13975: Bolus Injection of Landiolol Hydrochloride, Ultrashort-Acting β1-Selective Antagonist, is Excellent Premedication for Multidetector-Row Computed Tomography Coronary Angiography

Abstract

Background: We evaluated the efficacy and safety of a bolus injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as an additional treatment after premedication with an oral β-blocker to reduce heart rateprior to multidetector-row computed tomography (MDCT) coronary angiography.

Methods: A total of 458 patients who underwent MDCT coronary angiography were retrospectively enrolled. Image quality and hemodynamic parameters were compared in patients before and after approval of landiolol (n=229, respectively). If heart rate reduction was insufficient after premedication with an oral β-blocker, a bolus injection of landiolol (n = 66) or other drugs (n = 30) was used.

Results: Heart rates before scanning in patients receiving landiolol were similar to those receiving other drugs. Heart rate was significantly reduced around 5 minutes after injection of landiolol and recovered shortly. However, systolic blood pressure did not decrease significantly and adverse effect was not observed except for one patient who received other additional drugs and developed low blood pressure for which an intravenous hypertensive agent was necessary. Among all patient (n=458), the percentage of evaluable segments was significantly higher in patients after approval of landiolol than in patients before approval of landiolol (98.5 % vs. 97.8 %, p =0.03). In patients who received additional pretreatment (n=96), the percentage of evaluable images per segment in patients before approval of landiolol was greater than that in patients after approval of landiolol (99.3 % and 97.4 %, p < 0.01). The amount of time from the beginning of the visit to the outpatient clinic to the end of the CT scan was significantly shorter in patients after approval of landiolol (n=229) than in patients before approval of landiolol (n=229) (90 ± 13 vs. 159 ± 45 min, respectively, p < 0.01).

Conclusions: Single injection of landiolol hydrochloride reduced heart rate sufficiently without significantly decreasing systolic blood pressure and produced a high percentage of evaluable images, suggesting that one shot of landiolol hydrochloride as an additional pretreatment is feasible in MDCT coronary angiography.