Researchers report that an investigational anti-hypertensive therapy may perform better in controlling blood pressure than standard treatments for patients undergoing heart surgery, during a presentation at the American College of Cardiology's 56th Annual Scientific Session.
Another study found that measuring a certain peptide can help evaluate dyspnea (shortness of breath) as heart- or lung-related in the general population. ACC.07 is the premier cardiovascular medical meeting, bringing together specialists from around the world to further breakthroughs in cardiovascular medicine.
Blood Pressure Control With Clevidipine Compared With Nitroglycerin, Sodium Nitroprusside, or Nicardipine in the Treatment of Perioperative Hypertension: Results of the Three Randomized ECLIPSE Trials (Presentation Number: 415-8)
While nitroglycerin and sodium nitroprusside have been utilized effectively in patients undergoing cardiac surgery to control blood pressure, a new therapy called clevidipine may perform even better, according to researchers at Duke University School of Medicine. Three separate studies evaluated clevidipine, a novel third-generation intravenous (IV) dihydropyridine calcium channel blocker, to measure blood pressure control against standard alternative agents.
The studies, collectively known as ECLIPSE (Evaluation of CLevidipine In the Postoperative Treatment of Hypertension Assessing Safety Events), compared clevidipine to each of three standard therapies: nitroglycerin, nitroprusside or nicardipine. The studies assessed blood pressure control by calculating the magnitude and duration of episodes when patients' blood pressure went above or below predetermined acceptable ranges, based on the area under the blood-pressure-monitoring curve (AUC) that was outside the upper or lower limits of the range during surgery and for 24 hours afterwards.
The first two ECLIPSE studies found that patients treated with clevidipine experienced significantly improved blood pressure control over those who received nitroglycerin (6.02 vs. 14.88 AUC) or nitroprusside (8.94 vs. 17.28 AUC) (p < 0.05 for both studies). The third study found no significant difference in blood pressure control between clevidipine and nicardipine (5.27 vs. 5.67 AUC). The safety outcomes were similar for all medications. In a separate but supporting study, the same research team found that a higher AUC in cardiac surgery patients is a significant indicator of increased 30-day mortality.
"More research is needed to confirm the benefits of clevidipine, but these initial results against three very commonly used therapies demonstrate a new potentially valuable alternative, which is very encouraging," said Solomon Aronson, M.D., of Duke University Medical Center and lead author of the study. "With a better understanding of how to effectively control blood pressure during cardiac surgery, we believe we can significantly improve the outcomes of those operations, all while ensuring patient safety."
Plasma Pro-B-Type Natriuretic Peptide in Discriminating Between Cardiac and Pulmonary Dyspnea in the Population (Presentation Number: 415-4)