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Nitroglycerin withdrawal increases endothelium-dependent vasomotor response to acetylcholine

^a Division of Cardiology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

View larger version (10K): [in a new window]   Figure 1 Percent vasoconstriction of the LAD in response to ACh in the morning (AM, open bars) and afternoon (PM, solid bars) in the non-NTG and NTG groups. There was a significant increase in the degree of vasoconstriction in the NTG group after removal of the transdermal NTG patch and also a significant difference in the vasomotor response between the two groups. *p = 0.04 vs. NTG morning response. Data are expressed as the mean value ± SEM.

View larger version (69K): [in a new window]   Figure 2 Coronary angiograms from patients in the non-NTG group (panel A) and NTG group (panel B). The angiograms were obtained at the time of the morning control solution of D5W (Control AM), during 10–4 mol/liter of ACh in the morning (ACh–4 AM), during the afternoon control solution of D5W (Control PM) and during 10–4 mol/liter of ACh in the afternoon (ACh–4 PM). The white arrow identifies the LAD.