Clevidipine in the treatment of perioperative hypertension: assessing safety events in the ECLIPSE trials

Abstract

Clevidipine is an arterial, selective, dihydropyridine calcium channel blocker with an ultrashort half-life. In this prospective, randomized, open-label, parallel-comparison trial series, the safety and efficacy of intravenous clevidipine with nitroglycerin, sodium nitroprusside and nicardipine in hypertensive patients during cardiac surgery were compared. No differences in the incidences of myocardial infarction, stroke or renal dysfunction were observed between treatment groups. Mortality was similar between the clevidipine–nitrogylcerine- and clevidipine–nicardipine-treated groups, whereas mortality appeared to be greater in the sodium nitroprusside group compared to clevidipine (p = 0.04 in a univariant analysis). Clevidipine was significantly more effective in blood pressure control compared with nitroglycerin (p = 0.0006) or sodium nitroprusside (p = 0.003) and was associated with fewer blood pressure excursions compared with nicardipine as a predetermined blood pressure range was narrowed.

Keywords::

• antihypertensive
• blood pressure
• calcium antagonist
• calcium channel blocker
• cardiac surgery
• clevidipine
• coronary artery bypass grafting
• dihydropyridine
• hypertension
• nitroglycerin
• nitroprusside
• perioperative
• valve surgery

Acknowledgements

The author gratefully acknowledges the work of the GPRO study group/ECLIPSE investigators in the conduct of this trial. The author would also like to thank Richard Pistolese for his assistance in the preparation and review of this manuscript.

Financial & competing interests disclosure

Funding for this study was provided by The Medicines Company, Parsippany, NJ, USA. Solomon Aronson has received consultant fees and/or honoraria related to advisory activities from The Medicines Company. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.