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Medical Therapy - Nitrates

Nitroglycerine, the oldest of the therapies, has relatively few trials to compare. A recently completed meta-analysis, published in the Cochrane database, documents the experience of perioperative nitroglycerine in 11 trials (7 in cardiac surgery) and 1001 patients. The nitrates showed a clear improvement in perioperative ischemia over placebo. Nicorandil appeared to have superior properties compared to the other nitrates. The effects of nitrates have also been compared to calcium channel blockers in 6 cardiac surgery trials. Ischemia was reduced 50% more with calcium channel blockers as compared to nitrates.


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