Effects of Nicorandil on the Clinical and Laboratory Outcomes of Unstable Angina Patients after Coronary Angioplasty

Document Type : Original Article

Authors

1 Cariodiologist, Cardiovascular Research Center,Ghaem Hospital,Faculty Of Medicine,Mashhad Univrersity of Medical Sciences,Mashhad,Iran

2 Cariodiologist, Cardiovascular Research Center,Ghaem Hospital,Faculty of Medicine,Mashhad Univrersity of Medical Sciences, Mashhad,Iran

3 Cariodiologist, Cardiovascular Research Center,Ghaem Hospital,Faculty of Medicine,Mashhad Univrersity of Medical Sciences,Mashhad,Iran

4 Cariodiologist ,Ghaem Hospital, Faculty of Medicine,Mashhad Univrersity of Medical Sciences,Mashhad,Iran

5 Cariodiologist,Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: Ischemic preconditioning mediated by potassium channels is a physiological protective mechanism, . It is hypothesized that Nicorandil, which is a potassium channel activator, could protect the heart via preconditioning.
Materials and Methods:This clinical trial was conducted on 162 patients undergoing percutaneous coronary intervention (PCI) in Quem hospital, from Jan2013 to Jan 2014,patients  divided into two groups. The first group received standard treatment plus Nicorandil (10 mg, twice daily) for three days before and after angioplasty. The second group received standard treatment after PCI.
Results: Cardiac enzyme levels were significantly lower in the Nicorandil group at 6 and 12 hours after angioplasty,(p value=0.001) while no significant differences were observed in the symptoms and four-month prognosis of the study groups(p value=0.8).
Conclusion:It is recommended that a randomized clinical trial be conducted for the close evaluation of the effects of Nicorandil on unstable angina patients.

Keywords

References

1- Keith AAF, Philippe GS, Kim AE, Shaun GG, Frederick Jr AA, Christopher BG, Marcus DF, Andrzej B, Ann Q, Joel MG, GRACE Investigators. Decline in rates of death and heart failure in acute coronary syndromes, 1999—2006. JAMA2007;297:1892-900.
2. Sakata Y, Kodama K, Komamura K, Lim YJ, Ishikura F, Hirayama A, et al. Salutary effect of adjunctive intracoronary nicorandil administration on restoration of myocardial blood flow and functional improvement in patients with acute myocardial infarction. Am Heart J 1997; 133: 616 – 621.
3. Kawai Y, Hisamatsu K, Matsubara H, Dan K, Akagi S, Miyaji K, et al. Intravenous administration of nicorandil immediately before percutaneous coronary intervention can prevent slow coronary flow phenomenon. Eur Heart J 2009; 30: 765 – 772.
4. Ishii H, Ichimiya S, Kanashiro M, Amano T, Imai K, Murohara T,et al. Impact of a single intravenous administration of nicorandil before reperfusion in patients with ST-segment-elevation myocar-dial infarction. Circulation 2005; 112: 1284 – 1288.
5. Ito H, Taniyama Y, Iwakura K, Nishikawa N, Masuyama T, Kuzuya T, et al. Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol 1999; 33: 654 – 660.
6. Iwakura K, Ito H, Okamura A, Koyama Y, Date M, Higuchi Y, et al. Nicorandil treatment in patients with acute myocardial infarc-tion: A meta-analysis. Circ J 2009; 73: 925 – 931.
7-Stone GW, Peterson MA, Lansky AJ, Dangas G, Mehran R, Leon MB. Impact of normalized myocardial perfusion after successful angioplasty in acute myocardial infarction. J Am Coll Cardiol 2002;39: 591 – 597.
8-Gibson CM, Cannon CP, Daley WL, Dodge Jr JT, Alexander B, Marble SJ, et al. TIMI frame count: A quantitative method of assessing coronary artery flow. Circulation 1996; 93: 879 – 888.
9- Donald E. Cutlip, Richard E. Kuntz, Cardiac Enzyme Elevation After Successful Percutaneous Coronary Intervention Is Not an Independent Predictor of Adverse Outcomes. Circulation. 2005; 112: 916-923
10- Belsey J, Savelieva I, Mugelli A, Camm AJ. Relative efficacy of antianginal drugs used as add-on therapy in patients with stable angina: A systematic review and meta-analysis. Eur J Prev Cardiol. 2015 Jul;22(7):837-48.
11- Hirohata A, Yamamoto K, Hirose E, Kobayashi Y, Takafuji H, Sano F, Matsumoto K, et al. Nicorandil prevents microvascular dysfunction resulting from PCI in patients with stable angina pectoris: a randomised study. EuroIntervention. 2014 Jan 22;9(9):1050-6.
12-Hiroshi Ito, Yoshiaki Taniyama, Katsuomi Iwakura, Nagahiro Nishikawa, Tohru Masuyama, et al. Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol. 1999;33(3):654-660.
13- IONA Study Group. Effect of nicorandil on coronary events in patients with stable angina: the impact of nicorandil in angina(IONA) randomized trial. Lancet 2002;359:1269—75.
14-Kasama S, Toyama T, Sumino H, Kumakura H, Takayama Y,Ichikawa S, et al. Long-term nicorandil therapy improves car-diac sympathetic nerve activity after reperfusion therapy inpatients with first acute myocardial infarction. J Nucl Med2007;48:1676-82.
Journal of Cardio-Thoracic Medicine
Volume 4, Issue 3
September 2016
Pages 465-467

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