Author + information
- Carlos Leon Alviar,
- Alejandra Gutierrez,
- Leslie Cho,
- Amar Krishnaswamy,
- Amr Saleh,
- A. Lincoff,
- Eric Roselli,
- Michael Militello and
- Venu Menon
Background: Sodium Nitroprusside (SNP) is a preferred agent for the treatment of high blood pressure (BP) during acute aortic dissection (AAD) if BP remains elevated after heart rate (HR) control with beta blockers. The increasing cost of SNP led us to assess the efficacy and safety of intravenous clevedipine (CLE), a calcium channel blocker with quick onset of action, short half-life and significantly lower costs than SNP, in patients presenting with AAD.
Methods: We performed a retrospective analysis of patients admitted to the Cleveland Clinic CCU from 2013-16with the diagnosis of AAD comparing BP at different time-points and clinical characteristics of patient receiving SNP vs. CLE.
Results: A total of 85 patients with aortic pathology received CLE and 50 received SNP. Clinical and demographic characteristics were similar in both groups, except for a higher incidence of abdominal aortic aneurysm in the CLE group and for a trend towards higher use of labetalol in the CLE group. Incidence of hypertension, diabetese, coronary disease and chronic kidney disease did not differ. There were no significant differences in BP or HR at 1, 3 and 6 hours after starting either infusion. The rates of hypotension, bradycardia and in-hospital mortality did not differ. Time to achieve BP control was also similar between groups (Table).
Conclusions: IV CLE appears to be a safe and effective alternative to SNP for the management of high BP during AAD. CLE could represent a cost effective therapy providing similar outcomes than SNP.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Vascular Medicine: Emerging Concepts in Clinical Vascular Diseases
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1254-355
- 2017 American College of Cardiology Foundation