Table 1. Best evidences Topics (BETs): ‘Calcium-channel use after RA grafting’.
Study, Year Study type Calcium Channel Blocker Groups Follow-up Conclusion
Broadman et al. Sample size=60 199613
Case control
Diltiazem 240 mg daily
a) N=28 with CB b) N=28 no CB
Mean 3-months
No difference in terms of patency rate between the two groups
Acar et al3 Sample size=50 1998
Case control
Diltiazem 250 mg daily
a) N=27 with CB b) N=23 no CB
4/7-years
No differences in terms of graft failure
Possati et al.14 Sample size=68 1998
Case-control
Diltiazem 120 mg twice a day
After the 1 year those without scintigraphic or angiographic evidence of RA territory ischemia assigned to: a) N=29 continued CB b) N=31 suspended CB
5-years
No differences in RA graft status could be shown between groups who continued or suspended therapy with calcium channel blockers after 1 year.
Arena et al Sample size=50 200016
RCT
Nifedipine 40 daily for 6 months post-op
a) N=26 with CB b) N=24 no CB
16-24 months
No difference in terms of patency rate between the two groups
Shapira et al.17 Sample size=161 2000
RCT
Diltiazem and GTN
a) N=77 patients with diltiazem infusion for 24 h and daily for 6 months thereafter n=77 b) N= 84 patients with GTN infusion for 24 h and daily nitrate therapy for 6 months thereafter.
6-months
Major in-hospital and follow-up clinical end points (mortality, major morbidity, myocardial infarction, use of inotropic agents, the need for cardiac catheterization, and reintervention) similar between the study groups
Gaudino et al. 18 Sample size=120 2001
RCT
Diltiazem 120 mg/day
a) N=57 patients suspended CB after 1 year b) N=63 patients with chronic CB use
5 -year
No difference in graft patency, graft reactivity, myocardial ischemia or clinical outcomes
Moran et al.21 Sample size=115 2001
Case-control
Diltiazem 1 μg/kg/min intraoperatively then 180 mg/day for 1 year
a) N=63 patients with CB b) N=52 patients with no CB
1-year
The degree of the native coronary artery stenosis influenced the patency rate of RA, independent of the CB
Possati et al.15 Sample size=90 2003
Case-control
Diltiazem 120 mg daily
After 1 year, a) N=51 patients stopped CB b) N=49 patients on CB
105±9 months
No differences in graft patency between two groups
Cameron et al.22 Sample size=50 2004
Case-control
Diltiazem / amlodipine / verapamil /nifedipine
a) N=37 with CB b) N=23 no CB
5-years
No correlation found between CB usage and angiographic patency
Gaudino et al.19 Sample size=100 2005
RCT
Diltiazem 120 mg daily
a) N=53 patients with CB early regimen b) N=47 patients with no CB
1-year
No difference graft patency / reactivity / ischemia
Radial Artery Patency Study23 Sample size=440 2006 RCT Post-hoc analysis
Nifedipine for 6 months post-op
a) N=419 patients with compliance to CB b) N=21 patients with no compliance to CB
1-year
The incidence of string sign (RA spasm) was not affected by the compliance with the prescribed CB.
Radial Artery Database International ALliance24 Sample size=732 2019 RCT Post-hoc analysis
Diltiazem / amlodipine
a) N=502 patients with CB B) N=230 patients with no CB
Median angiographic follow-up 55 months
CB therapy was found to be consistently associated with a significant lower risk of MACE and RA graft occlusion
CB: Calcium-channel blocker. MACE: Major adverse cardiac events. RCT: randomized controlled trial. CB: Calcium-channel blocker. MACE: Major adverse cardiac events. RCT: randomized controlled trial. CB: Calcium-channel blocker. MACE: Major adverse cardiac events. RCT: randomized controlled trial. CB: Calcium-channel blocker. MACE: Major adverse cardiac events. RCT: randomized controlled trial. CB: Calcium-channel blocker. MACE: Major adverse cardiac events. RCT: randomized controlled trial. CB: Calcium-channel blocker. MACE: Major adverse cardiac events. RCT: randomized controlled trial.