Safety of Landiolol Hydrochloride as a Premedication for Producing an Appropriate Heart Rate for Multidetector-Row Computed Tomography Coronary Angiography

Abstract

Background: We evaluated the safety of a bolus injection of landiolol hydrochloride, an ultrashort-acting beta1-selective antagonist, as a premedication prior to multidetector-row computed tomography coronary angiography (CTA).

Methods: The subjects consisted of 176 patients (M/F = 64:112, 67 11 years) who had heart rate (HR) at rest ? 70 beats/min (bpm) and underwent CTA. Systolic/diastolic blood pressure (SBP/DBP) and HR were measured before and after the administration of landiolol.

Results: SBP/DBP and HR upon entry to the CT room were 136 17/80 11 mm Hg and 83 10 bpm, respectively. HR was significantly reduced at the time of CTA scan (62 7 bpm). Next, we divided the patients into three groups according to HR upon entry to the CT room: 70 - 79 bpm (n = 76), 80 - 89 bpm (n = 60) and ? 90 bpm (n = 40). HR at the time of CTA scan was significantly lower than that upon entry to the CT room in all three groups: 70 - 79 bpm (74 3 bpm upon entry to the CT room to 61 6 bpm at the time of CAT scan), 80 - 89 bpm (84 3 to 63 7 bpm) and ? 90 bpm (98 6 to 65 7 bpm). Although SBP/DBP was significantly decreased after the CTA scan (123 18/72 12 mm Hg), landiolol had no severe adverse events throughout CTA.

Conclusion: In conclusion, a bolus injection of landiolol reduced HR by about 20 bpm without any severe adverse effects. Thus, a bolus injection of landiolol hydrochloride may be a suitable pretreatment for controlling HR in CTA.

J Clin Med Res. 2018;10(1):22-26
doi: https://doi.org/10.14740/jocmr3213w