Effects of Nicorandil, Isosorbide Mononitrate, or Diltiazem on Radial Artery Grafts After CABG: The Randomized ASRAB-Pilot Trial
Authors' conclusion
In this pilot trial, treatment with nicorandil or isosorbide mononitrate was associated with a lower RA graft failure rate compared with diltiazem. Larger hypothesis-testing trials are warranted.
Study context
- Population
- Patients who underwent coronary artery bypass grafting using radial artery (RA) graftsrandomized, 149 with 177 RA grafts assessed at least once by coronary computed tomography angiography
- Participants
- 150 patients
- Comparison
- Nicorandil, isosorbide mononitrate, or diltiazem on RA grafts
- Nicorandiln = 50
- Isosorbide mononitraten = 50
- Diltiazemn = 49
- Primary endpoint
- RA graft failure (modified Fitzgibbon grade B, S, or O), assessed by coronary computed tomography angiography
- Follow-up
- 1 and 24 weeks
Methodological detailssingle-center
- Single-center
Primary result
As reported in the abstract
Difference (95% CI)
Nicorandil vs diltiazem1 week; 19.4%vs 25.0%; lower with nicorandil
−5.6%(−20.6% to 9.3%)
Isosorbide mononitrate vs diltiazem1 week; 18.2%vs 25.0%; lower with isosorbide mononitrate
−6.8%(−21.8% to 8.6%)
Nicorandil vs isosorbide mononitrate1 week; 19.4%vs 18.2%; slightly higher with nicorandil
1.2%(−13.3% to 15.2%)
Nicorandil vs diltiazem24 weeks; 16.1%vs 27.8%; lower with nicorandil
−11.7%(−26.6% to 3.4%)
Isosorbide mononitrate vs diltiazem24 weeks; 12.5%vs 27.8%; lower with isosorbide mononitrate
−15.3%(−29.8% to −0.2%)
Nicorandil vs isosorbide mononitrate24 weeks; 16.1%vs 12.5%; slightly higher with nicorandil
3.6%(−9.6% to 16.4%)
Original publication
Effects of Nicorandil, Isosorbide Mononitrate, or Diltiazem on Radial Artery Grafts After CABG: The Randomized ASRAB-Pilot Trial. Circ Cardiovasc Interv. Published 24 March 2025. doi:10.
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