The haemodynamic effect of the 5HT(1) agonist BMS-180048: a class effect of triptans?

Aims To investigate the effects of an intravenous infusion of BMS-180048, a novel 5HT(1)-like agonist, on the systemic, pulmonary and coronary circula tions in patients undergoing diagnostic cardiac catheterisation. Methods Ten patients (mean age 55 years (range 41-65)) were studied during diagnostic cardiac catheterisation. The haemodynamic response to an intrave nous (i.v.) infusion for 30 min of BMS-180048 (0.56 mg kg(-1) h(-1) for 10 min and 0.39 mg kg(-1) h(-1) for 20 min) was assessed via a 7F Swan Ganz ca theter and thermodilution cardiac output system. Quantitative coronary angi ography was performed at 10 min intervals. Results BMS-180048 caused a significant increase in systemic arterial systo lic blood pressure (rise of 32.5 mmHg, 95% CI 24,44.5) P=0.009), pulmonary artery systolic (12.2 mmHg, 95% CI 6.8,18.5; P=0.009) and diastolic pressur es (8.5 mmHg, 95% CI 5.0,13.8; P=0.009), right atrial pressure (4 mmHg, 95% CI 1.5,5.2; P=0.013) and pulmonary capillary wedge pressure (9.5 mmHg 95% CI 5.2, 14.0; P=0.009). There was no significant change in cardiac output ( 0.11 min(-1), 95% CI -0.17, 0.57, P>0.05). Mean coronary artery diameter in the proximal coronary segments decreased by 0.73 mm (95% CI -1.22, -0.15; P=0.03) at 35 min. The corresponding reduction in middle segments was 0.26 mm (95% CI -0.395, -0.08; P=0.02). There was a non-significant trend to con striction in the most distal segments of 0.28 mm (95% CI -0.68, 0.015); P=0 .06). One patient experienced chest pain with ECG changes suggestive of isc haemia. Conclusions BMS-180048 displayed a cardiovascular profile similar to that p reviously reported for sumatriptan. These changes appear to reflect a class effect of these agents.