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

Abstract

BACKGROUND Nicorandil 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 AND METHODS One 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. RESULTS There 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). CONCLUSIONS Nicorandil exerts cardioprotective effects on CHD patients undergoing elective PCI by decreasing PCI-related myocardial injury and rate of no-reflow and improvement of LVEF.

Figure 1

Comparison of the rate of no-reflow and blood frames. A total of 100 CHD patients were assigned to the control group (n=48) and nicorandil group (n=52). After PCI, all patients underwent coronary angiogram. (A) Number of patients with reflow and no-reflow in the 2 groups. (B) Blood frames in the 2 groups. CHD – coronary heart disease; PCI, percutaneous coronary intervention. * P<0.05 compared to the control group.

Figure 2

Comparison of levels of cTnI, CK-MB, MPO, and MDA. The plasma levels of cTnI, CK-MB, MPO, and MDA before and at 6, 18, and 24 h after PCI in the 2 groups were analyzed. (A) Plasma levels of cTnI. (B) Plasma levels of CK-MB. (C) Plasma levels of MPO. (D) Plasma levels of MDA. cTnI – cardiac troponin I; CK-MB – creatine kinase-MB; MPO – myeloperoxidase; MDA – malondialdehyde; PCI – percutaneous coronary intervention. * P<0.05 compared to the control group.

Figure 3

Comparison of SBP, MBP, HR, and LVEF. The SBP, MBP, HR, and LVEF before and 3 months after PCI in the 2 groups were recorded. (A) SBP before and 3 months after PCI in the 2 groups. (B) MBP before and 3 months after PCI in the 2 groups. (C) HR before and 3 months after PCI in the 2 groups; (D) the LVEF before and after PCI 3 months in the 2 groups. SBP – systolic blood pressure; DBP – mean blood pressure; HR – heart rate; LVEF – left ventricular ejection fractions; PCI – percutaneous coronary intervention. * P<0.05 compared to the control group; ** P<0.01 compared to the control group.