Cardioprotective Effects of Nicorandil on Coronary Heart Disease Patients Undergoing Elective Percutaneous Coronary Intervention

Abstract

BackgroundNicorandil is a nicotinamide ester commonly prescribed for treatment of patients with coronary heart disease (CHD). In the present study, we aimed to explore the cardioprotective effects of nicorandil on CHD patients undergoing elective percutaneous coronary intervention (PCI).Material/MethodsOne hundred patients with CHD undergoing PCI were randomly divided into a control group (n=48) and a nicorandil group (n=52). Patients in the control group received traditional therapy, and while patients in the nicorandil group received nicorandil before PCI in addition to the traditional therapy. After PCI, all patients underwent coronary angiogram, and TIMI frame count (TFC) was calculated. Plasma levels of cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), myeloperoxidase (MPO), and malondialdehyde (MDA) were determined before and at 6, 18, and 24 h after PCI. Moreover, systolic blood pressure (SBP), mean blood pressure (DBP), heart rate (HR), and left ventricular ejection fractions (LVEF) were recorded before and 3 months after PCI.ResultsThere was a significant difference in the rate of no-reflow (P=0.036) between the 2 groups. The blood frames and levels of cTnI, CK-MB, MPO, and MDA in the nicorandil group were significantly decreased compared to the control group (all P<0.05). Moreover, administration of nicorandil markedly decreased SBP, MBP, and HR, but obviously increased LVEF at 3 months after PCI (P<0.05 or P<0.01).ConclusionsNicorandil exerts cardioprotective effects on CHD patients undergoing elective PCI by decreasing PCI-related myocardial injury and rate of no-reflow and improvement of LVEF.

Effects of Nicorandil on All-Cause Mortality and Cardiac Events in CAD Patients Receiving PCI

“…20) Similarly, cardioprotective effects of nicorandil were also observed in coronary heart disease patients undergoing EPCI as demonstrated by the decrease in PCI-related myocardial injury, rate of no-reflow, and improvement of LVEF. 17) Our meta-analysis also demonstrated the benefits of nicorandil in reducing total mortality and CV death in patients undergoing PPCI or EPCI based on the low to moderate quality of evidence of outcomes. A total mortality benefit was only found in PPCI patients followed up no more than 30 days, and this may be explained by the fact patients are at higher risk during that period of time and benefit more from nicorandil.…”

“…Nicorandil has cardioprotective effects in coronary heart disease patients undergoing PCI. 16,17) Nicorandil could prevent the slow reflow/no flow phenomenon and reduce the elevation of creatine kinase-MB and cardiac troponin, indicators of myocardial damage in CAD patients undergoing primary PCI. 18,19) Its efficacy is also observed as an adjuvant therapy with PCI on EFFICACY OF NICORANDIL IN CAD RECEIVING PCI 4 exp percutaneous coronary intervention/ 5 (coronar* and percutaneous* and (intervent* or revascular* or angioplast*)).mp.…”

The impact of oral nicorandil pre-treatment on ST resolution and clinical outcome of patients with acute ST-segment elevation myocardial infarction undergoing primary coronary angioplasty: A randomized placebo controlled trial

“…This finding of our study was in contrast to the most of reports on the reduction of no-reflow phenomenon with either intravenous or intracoronary nicorandil administration. 8,10,[18][19][20] The following mechanism may be responsible for this lack of ischemia/reperfusion injury reduction in oral nicorandil as applied in the present study: longer absorption time of oral nicorandil compared to intravenous or intracoronary forms, which may lead to delayed delivery of the medication to myocardium and thus impeding adequate serum levels for cardioprotection during primary angioplasty. Larger oral doses and increasing the times of administration may be promote the effects of the medicine, but could potentially deteriorate hemodynamic status of the patients, due to the hypotensive effect of nicorandil.…”

Nicorandil in the prevention of cardiac damage and type 4A myocardial infarction with planned percutaneous coronary intervention in patients with atherosclerosis of coronary arteries

“…Так, медианный уровень КК-МВ через 24 ч после ЧКВ в группе никорандила составил 2,30 нг/мл против 2,05 нг/мл в группе контроля, p=0,08. При этом степень прироста КК-МВ в группе никорандила была также ниже, по сравнению с группой контроля (2,48 нг/мл против 1,05 нг/мл, p=0,06), что подтверждает кардиопротективные эффекты препарата [10,11]. Очевидным доказательством снижения степени повреждения миокарда является факт увеличения числа "малых" приростов вч-тропонина через 24 ч после ЧКВ в ущерб "большим" (p=0,05).…”