Coronary disease & ACSRandomised controlled trial
Effect of Sublingual Nitroglycerin on Absolute Coronary Blood Flow
- Randomised controlled trial
- double-blind
- placebo-controlled
- mechanistic
Between-group differences analysed by analysis of covariance; measurements repeated at 5 and 10 minutes
Authors' conclusion
Sublingual NTG induced a significant decrease in left ventricular preload and afterload, resulting in a marked decrease in myocardial work. This was associated with a significant and adaptive decrease in absolute coronary blood flow.
Study context
- Population
- Patients with suspected angina undergoing cardiac catheterization
- Participants
- 40 patients
- Comparison
- Sublingual nitroglycerin (NTG) vs placebo
- NTGn = 20
- Placebon = 20reference
- Primary endpoint
- Absolute coronary blood flow (continuous intracoronary thermodilution)
Primary result
Absolute coronary blood flow
Estimated mean difference
−8.7 mL/min
95% CI −13.4 to −3.9
P = 0.001
NTG vs Placebo
estimated mean difference −8.7 mL/min (95% CI −13.4 to −3.9); P = 0.001
As reported in the abstract
Further findings
| Outcome | estimated mean difference (mm Hg) (95% CI) | P value | |
|---|---|---|---|
| LV end-diastolic pressure · 10 minutes · decrease of 38.1% (95% CI: 21.8%-54.4%) | −5.4 (−7.8 to −3.1) | P < 0.001 | |
| Aortic pressure · 10 minutes · decrease of 8.5% (95% CI: 5.3%-11.7%) | −8.6 (−12.2% to −5.1%) | P < 0.001 | |
| Distal coronary pressure · 10 minutes · decrease of 7.4% (95% CI: 3.7%-11.1%) | −7.1 (−10.6 to −3.7) | P < 0.001 | |
| −15−10−505Difference, mm Hg (linear scale) |
| Outcome | estimated mean difference (Wood units) (95% CI) | P value | |
|---|---|---|---|
| Microvascular resistance · increase of 8.0% (95% CI: 1.1%-14.9%) | 121.5 (15.3–227.8) | P = 0.026 | |
| −1000100200300Difference, Wood units (linear scale) |
Myocardial work
- Myocardial work decreased by 21.1% (95% CI: 15.4%-26.9%)
- estimated mean difference −8.9 mm Hg · s; 95% CI: −11.6 to −6.2 mm Hg · s; P < 0.001
Original publication
Effect of Sublingual Nitroglycerin on Absolute Coronary Blood Flow. JACC Cardiovasc Interv. Published 11 May 2026. doi:10.1016/j.jcin.2026.04.014
Summarised from the published abstract; every number is checked against it