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Perioperative Sublingual Isosorbide Dinitrate for the Prevention of Cardiac Complications in Cardiac Patients Undergoing Noncardiac Surgery

Northeast Cardiac Clinic and Research Institute, Wilkes-Barre, PA

One hundred fifty-two consecutive patients with a known or suspected diagnosis of atherosclerotic coronary artery disease were administered 5 mg sublingual isosorbide dinitrate 2 hours and/hour preoperatively and every 4 hours postoperatively for 3 days, for the prevention of cardiovascular morbidity and mortality, which could result from various noncardiac surgical procedures; 125 patients received general anesthesia. Cardiovascular complications occurred in 3 patients (1.9%). Two patients did not enter the study, owing to side effects of the medication (1.3%). The complications were 1 each (0.6%) of the following: atrial fibrillation, hypotension, and cardiac arrest. Mortality was 0%. These results are exceptionally favorable when compared to the average cardiovascular morbidity rate of 2.8% to 49% in patients assigned to various risk stratifications in the medical literature.

Angiology, Vol. 56, No. 6, 755-760 (2005)
DOI: 10.1177/000331970505600613


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