Additive effects of nicorandil on coronary blood flow during continuous administration of nitroglycerin.

Content Provider	Semantic Scholar
Author	Okamura, Atsushi Rakugi, Hiromi Ohishi, Mitsuru Yanagitani, Yoshihiro Shimizu, Masashi Nishii, Teppei Taniyama, Yoshiaki Asai, Tomohiro Takiuchi, Shin Moriguchi, Kouichi Ohkuro, Michiya Komai, Norio Yamada, Kiyoyasu Inamoto, Nozomu Otsuka, Atsuko Higaki, Jitsuo Ogihara, Toshio
Copyright Year	2001
Abstract	OBJECTIVES We examined whether patients with ischemic heart disease (IHD) should be treated with nicorandil, an adenosine triphosphate-sensitive potassium channel opener, in addition to the regular use of nitrates. BACKGROUND It has been reported that nicorandil possibly has additive effects on nitroglycerin (NTG) treatment for angina, but the mechanism is not clear. METHODS We directly measured anterograde coronary blood flow (CBF) with a Doppler guide wire to examine the effects of intravenous administration of NTG (0.3 mg) and nicorandil (6 mg) during continuous administration of NTG at a sufficient dose (25 microg/min) in subjects with normal and stenotic coronary arteries. RESULTS Additional systemic administration of NTG decreased anterograde CBF (normal -19.7%; stenotic -21.2%). In contrast, nicorandil increased anterograde CBF in both normal (54.6%) and stenotic (89.6%) coronary arteries, without the coronary steal phenomenon. There was a tendency toward nicorandil-dilated diameters in the patients with stenotic arteries (p = 0.06). There were no effects of additional administration on pulmonary artery wedge pressure. There was no difference in changes in heart rate and mean aortic blood pressure between NTG and nicorandil therapy. CONCLUSIONS These results suggest that in patients treated with nitrates, additional administration of nicorandil is more useful, in terms of increasing CBF, than additional administration of nitrates. Adjunctive use of nicorandil with nitrates may provide the further benefit of myocardial protection and may improve the prognosis of patients with IHD.
Starting Page	2H
Ending Page	8H
Page Count	7
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://www.onlinejacc.org/content/accj/37/3/719.full.pdf
PubMed reference number	11693742v1
Volume Number	37
Issue Number	3
Journal	Journal of the American College of Cardiology
Language	English
Access Restriction	Open
Subject Keyword	Adenosine Triphosphate Angina Pectoris Arteries Biologic Preservation Catheter guide wire, device Coronary artery Diameter (qualifier value) Forecast of outcome Heart Diseases Myocardial Infarction Myocardial Ischemia Nicorandil Nitrates Nitroglycerin Obstructive Ureterocele Patients Potassium Channel
Content Type	Text
Resource Type	Article