Objective-To determine whether percutaneous transluminal coronary angioplasty may be safely performed in cardiology centres in the United Kingdom without immediate on site cardiac surgical cover for complications arising at angioplasty.Design-Retrospective review of coronary angioplasties and complications in a hospital without on site cardiac surgical cover.Setting

1 The acute haemodynamic effects of i.v. pinacidil 0.2 mg kg-' infused over 8 min were studied in 10 normotensive patients undergoing cardiac catheterisation. 2 Mean arterial pressure fell from 94 ± 3 mmHg (mean ± s.e. mean) before infusion to 74 ± 3 mmHg at 10 min after commen--ng infusion (P ' 0.001) and during this time heart rate increased from 75 ± 4 to 106 ± 7 beats min-' (P < 0.001). Significant changes were recorded until the end of the observation period (70 min after commencing infusion). 3 Cardiac index increased from 3.2 ± 0.2 to 4.0 0.2 1 min-' m-2 (p < 0.001) and systemic vascular resistance fell from 16 ± 1 to 10 1 units (P < 0.001) at 10 min after commencing infusion. By the end of the observation period, the values had returned to pre-infusion levels. 4 Only small changes in pulmonary haemodynamics were observed. 5 These results indicate that pinacidil acts as a peripheral arteriolar vasodilator, and as such may have a role in the treatment of arterial hypertension and of cardiac failure.

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