Nitroglycerin Tolerance in Human Vessels: Evidence for Impaired Nitroglycerin Bioconversion

  title={Nitroglycerin Tolerance in Human Vessels: Evidence for Impaired Nitroglycerin Bioconversion},
  author={Peter R. Sage and Ivan S de la Lande and Irene A Stafford and Catherine Bennett and George Phillipov and John Stubberfield and John D Horowitz},
  journal={Circulation: Journal of the American Heart Association},
Background—The basis for progressive attenuation of the effects of organic nitrates during long-term therapy (nitrate tolerance) remains controversial; proposed mechanisms include impaired nitrate bioconversion resulting in decreased release of nitric oxide (NO) from nitrates and/or increased NO clearance through a reaction with incrementally generated superoxide (O2–). Methods and Results—Patients undergoing elective coronary artery bypass were randomized to receive 24 hours of intravenously… 

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