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Hemodynamic and coronary effects of intravenous eletriptan, a 5HT 1B/1D ‐receptor agonist
Author(s) -
Muir Douglas F.,
McCann Gerald P.,
Swan Lorna,
Clark Andrew L.,
Hillis W. Stewart
Publication year - 1999
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/s0009-9236(99)70057-3
Subject(s) - medicine , vascular resistance , cardiology , pulmonary wedge pressure , cardiac catheterization , blood pressure , coronary artery disease , anesthesia , pulmonary artery , placebo , hemodynamics , cardiac output , artery , alternative medicine , pathology
Objective To investigate the systemic, pulmonary, and coronary artery effects of eletriptan, a new 5HT 1B/1D ‐agonist in patients undergoing cardiac catheterization. Methods Ten patients (two men and eight women) without significant obstructive coronary artery disease were administered 3.33 μg/kg/min intravenous eletriptan after they were given a placebo infusion of 0.9% saline solution. Serial measurements of right heart and systemic pressures were taken at 5‐minute intervals during placebo infusion, eletriptan infusion, and a 30‐minute postinfusion period. Cardiac output by the thermodilution technique and coronary angiography were performed every 15 minutes. Quantitative coronary angiography was carried out to measure coronary artery dimensions. Results A small but statistically significant increase in occluded wedge pressure (7.4 versus 8.8 mm Hg; 95% confidence interval [CI], 0.74, 2.51; P < .01), right atrial pressure (5.3 versus 6.1 mm Hg; 95% CI, 0.0, 1.4; P < .05), and mean pulmonary artery pressure (13.2 versus 14.6 mm Hg; 95% CI, 0.0, 2.7; P = .05) was observed during the eletriptan infusion compared with placebo. A statistically significant increase in systemic vascular resistance (1256 versus 1519 dyne/sec/cm −5 ; 95% CI, 126, 398; P < .01) and pulmonary vascular resistance (76.4 versus 100.8 dyne/sec/cm −5 ; 95% CI, 1.9, 46.9; P < .05) was observed in the period after drug infusion. No overall effect was observed on the coronary arteries, although a segmental right coronary artery constriction developed in one patient, possibly as a result of catheter‐induced spasm. Conclusions Eletriptan, a 5HT 1B/1D ‐agonist effective in migraine, causes no significant coronary artery constriction in patients without significant obstructive coronary artery disease. This finding may reflect a relative selectivity for the 5HT 1D ‐receptor subtype. Clinical Pharmacology & Therapeutics (1999) 66 , 85–90;