Coronary microvascular response to intracoronary administration of nicorandil

Hongo, Minoru; Takenaka, Hiroaki; Uchikawa, Shinichiro; Nakatsuka, Tatsuya; Watanabe, Noboru; Sekiguchi, Morie

doi:10.1016/0002-9149(95)80029-r

Cited by 50 publications

(18 citation statements)

References 26 publications

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“…ATP-sensitive K ϩ channel openers, such as nicorandil, are a relatively new class of drug introduced for the treatment of angina (51a). The efficacy of nicorandil is related to its coronary and peripheral vasodilator actions (25,51). Given that diabetes mellitus is one of the major risk factors for ischemic heart disease, the potential for combined administration of sulfonylureas and nicorandil exists.…”

Section: Physiological and Clinical Implicationsmentioning

confidence: 99%

Inhibition of vascular ATP-sensitive K⁺channels does not affect reactive hyperemia in human forearm

Farouque

Meredith

2003

American Journal of Physiology-Heart and Circulatory Physiology

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The extent to which ATP-sensitive K(+) channels contribute to reactive hyperemia in humans is unresolved. We examined the role of ATP-sensitive K(+) channels in regulating reactive hyperemia induced by 5 min of forearm ischemia. Thirty-one healthy subjects had forearm blood flow measured with venous occlusion plethysmography. Reactive hyperemia could be reproducibly induced (n = 9). The contribution of vascular ATP-sensitive K(+) channels to reactive hyperemia was determined by measuring forearm blood flow before and during brachial artery infusion of glibenclamide, an ATP-sensitive K(+) channel inhibitor (n = 12). To document ATP-sensitive K(+) channel inhibition with glibenclamide, coinfusion with diazoxide, an ATP-sensitive K(+) channel opener, was undertaken (n = 10). Glibenclamide did not significantly alter resting forearm blood flow or the initial and sustained phases of reactive hyperemia. However, glibenclamide attenuated the hyperemic response induced by diazoxide. These data suggest that ATP-sensitive K(+) channels do not play an important role in controlling forearm reactive hyperemia and that other mechanisms are active in this adaptive response.

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Section: Physiological and Clinical Implicationsmentioning

confidence: 99%

Inhibition of vascular ATP-sensitive K⁺channels does not affect reactive hyperemia in human forearm

Farouque

Meredith

2003

American Journal of Physiology-Heart and Circulatory Physiology

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“…Indeed, experimental and clinical studies have demonstrated that nicorandil dilates the coronary resistance arteries more strongly than nitroglycerine. [21][22][23] Another mechanism may be that nicorandil attenuates platelet aggregation and neutrophil adhesion; [24][25][26] because interstitial edema, cell swelling, and capillary plugging by aggregated platelets and activated neutrophils contribute to a progressive increase in microvascular resistance, this effect may attenuate microvascular resistance, and thereby increase myocardial blood flow. Because verapamil does not attenuate the activity of neutrophils, the superior efficacy of nicorandil over verapamil observed in this study may be related to this effect of nicorandil.…”

Section: Circulation Journal Vol66 December 2002mentioning

confidence: 99%

Effect of Intracoronary Nicorandil Administration on Preventing No-Reflow/Slow Flow Phenomenon During Rotational Atherectomy

Tsubokawa

Ueda

Sakamoto

et al. 2002

Circ J

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“…12,13) While calcium channel blockers may not always be effective in treating microvascular angina, 14) nicorandil can be an effective antiangina drug for the treatment of patients with microvascular angina secondary to the administration of a bevacizumab-containing regimen.…”

Section: Discussionmentioning

confidence: 99%

Bevacizumab-Related Microvascular Angina and Its Management with Nicorandil

et al. 2017

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SummaryBevacizumab, an inhibitor of vascular endothelial growth factor (VEGF)-A, is currently used to treat patients with ovarian or colon cancer. While several cardiovascular toxicities related to bevacizumab-containing regimens have been reported, the effect of bevacizumab on the coronary microcirculation has not been fully elucidated. Here we report a case of 54-year-old female patient who developed microvascular angina after a series of bevacizumab-containing chemotherapeutic regimen. The discontinuation of bevacizumab and nicorandil administration was effective in alleviating her chest discomfort and the ischemic changes on her ECG. This highlights the possibility that coronary microvascular angina can be induced in patients treated with bevacizumabcontaining chemotherapy. It should also be noted that nicorandil can be effective in managing microvascular angina.(Int Heart J 2017; 58: 803-805) Key words: Chemotherapy, VEGF, Avastin M icrovascular angina is defined as the development of angina pectoris due to reduced coronary flow in the very small coronary arteries, while the epicardial coronary arteries remain intact.1) Impairment of vascular endothelial function or microvascular spasm underlies the onset of microvascular angina. 2)Bevacizumab, an inhibitor of vascular endothelial growth factor (VEGF)-A, is currently used to treat patients with colon or ovarian cancer.3) While several types of cardiovascular toxicity related to bevacizumab-containing regimens, such as hypertension, thrombus formation, and heart failure, have been previously reported, 4,5) the effect of bevacizumab on the coronary microcirculation has not been clearly elucidated. Case ReportHere, we report a case of a 54-year-old female patient who developed microvascular angina after bevacizumab treatment. She had no risk factor for ischemic heart disease (IHD) including hypertension, diabetes, dyslipidemia, smoking, and family history for IHD. She was diagnosed with ovarian cancer at our hospital and an adnexectomy was carried out 10 years ago. Following the surgery, chemotherapy with taxane and carboplatin [five courses of paclitaxel (175 mg/m2 )], and carboplatin (AUC 6), and one course of docetaxel (70 mg/m 2 ) and carboplatin (AUC 5) was initiated. Splenectomy was carried out 6 years ago for the treatment of ovarian cancer metastasis, followed by six courses of paclitaxel (175 mg/m 2 ) and carboplatin (AUC 5). We detected the recurrence of her ovarian cancer 2 years ago and administrated nine courses of paclitaxel (175 mg/m 2 ) and carboplatin (AUC 5). After that, because of residual peritoneal dissemination, bevacizumab (1000 mg/body, 15 mg/kg) was given under her excellent performance status. Paclitaxel (175 mg/m 2 ) and carboplatin (AUC 5) were added at initial two courses.After six courses of bevacizumab-containing chemotherapeutic regimen, we noted that her blood pressure was elevated thereafter, and we started candesartan (4 mg/ daily) to control her blood pressure. Moreover, after 21 cycles of bevacizumab-containing chemotherapy...

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Coronary microvascular response to intracoronary administration of nicorandil

Cited by 50 publications

References 26 publications

Inhibition of vascular ATP-sensitive K⁺channels does not affect reactive hyperemia in human forearm

Inhibition of vascular ATP-sensitive K⁺channels does not affect reactive hyperemia in human forearm

Effect of Intracoronary Nicorandil Administration on Preventing No-Reflow/Slow Flow Phenomenon During Rotational Atherectomy

Bevacizumab-Related Microvascular Angina and Its Management with Nicorandil

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Coronary microvascular response to intracoronary administration of nicorandil

Cited by 50 publications

References 26 publications

Inhibition of vascular ATP-sensitive K+channels does not affect reactive hyperemia in human forearm

Inhibition of vascular ATP-sensitive K+channels does not affect reactive hyperemia in human forearm

Effect of Intracoronary Nicorandil Administration on Preventing No-Reflow/Slow Flow Phenomenon During Rotational Atherectomy

Bevacizumab-Related Microvascular Angina and Its Management with Nicorandil

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Inhibition of vascular ATP-sensitive K⁺channels does not affect reactive hyperemia in human forearm

Inhibition of vascular ATP-sensitive K⁺channels does not affect reactive hyperemia in human forearm