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Published on: May 28, 2019
Cardioprotection by opening of the K(ATP) channel in unstable angina. Is this a clinical manifestation of myocardial
D J Patel1, H J Purcell, K M Fox
1Royal Brompton and Harefield NHS Trust, London, UK.
European Heart Journal
|March 13, 1999
Summary
Nicorandil significantly reduced arrhythmias and transient myocardial ischemia in unstable angina patients. This cardioprotective drug, an ATP sensitive potassium channel opener, showed promising anti-ischemic and anti-arrhythmic effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Unstable angina (UA) poses significant cardiovascular risk.
- Nicorandil, an ATP-sensitive potassium channel opener, exhibits cardioprotective properties.
- Assessing nicorandil's efficacy in UA is crucial for patient management.
Purpose of the Study:
- To evaluate the anti-ischemic and anti-arrhythmic effects of nicorandil in patients with unstable angina.
- To assess the overall safety profile of nicorandil when added to standard UA treatment.
Main Methods:
- A multicenter, randomized, double-blind, placebo-controlled study.
- 188 patients with unstable angina received either nicorandil (20 mg twice daily) or placebo for at least 48 hours.
- Continuous Holter ECG monitoring and pain charts were used to assess endpoints.
Main Results:
- Nicorandil significantly reduced the incidence of arrhythmias compared to placebo (6.7% vs 17.2%, P=0.04).
- Fewer episodes of transient myocardial ischemia were observed in the nicorandil group (37 episodes vs 74 episodes).
- No significant differences in myocardial infarction or death rates were noted between groups.
Conclusions:
- Nicorandil, as an adjunct therapy for unstable angina, effectively reduces transient myocardial ischemia and arrhythmias.
- The anti-arrhythmic effects are likely secondary to its anti-ischemic action, possibly via ATP-sensitive potassium channel-mediated pharmacological preconditioning.
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