The implementation of cardioprotection with nicorandil from periprocedural damage during elective percutaneous coronary interventions in patients with stable coronary heart disease
- Authors: Gostishchev R.V1, Soboleva G.N1, Samko A.N1, Minasyan A.A1
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Affiliations:
- A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation
- Issue: Vol 20, No 5 (2018)
- Pages: 61-65
- Section: Articles
- URL: https://ogarev-online.ru/2075-1753/article/view/95006
- DOI: https://doi.org/10.26442/2075-1753_2018.5.61-65
- ID: 95006
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Abstract
The purpose of the study is to demonstrate such an effect of the nicorandil like the pharmacological preconditioning in patients with stable coronary heart disease (CHD) during elective percutaneous coronary intervention (PCI). Material and methods. The study included 88 patients with a stable form of CHD directed to the elective PCI. By the method of blind randomization (envelope method) two groups or patients were formed: 45 patients in the first group (main group) - for treatment with nicorandil (Cordinic, PIQ-FHARMA LLC) and 43 patients in the second group for standard therapy (comparison group). In both groups the basic antianginal therapy was allowed - b-blockers, calcium antagonists, ATE inhibitors/angiotensin II receptor blockers, statins, acetylsalicylic acid, blockers of P2Y12 receptor platelets. In the second group was allowed the admission of prolonged form of nitrates before PCI. Patients of the 1st group took nicorandil 2 days prior to PCI at a dose of 30 mg/day, 2 hours before PCI - 20 mg orally, after 6 hours after PCI - 10 mg nicorandil. Highly sensitive troponin (HS-Tn) as a biomarker of irreversible damage to the myocardium was evaluated before PCI and after PCI in 24 hours. Results. The obtained data shows the significant increase in HS-Tn in 24 hours after PCI in patients with no admission of nicorandil (117 ng/l) as compared with the nicorandil group (73 ng/l), p=0.04. There were significant differences in the 24 hours increment in HS-Tn in the control group, it was higher (112 ng/l) than in the nicorandil group (67 ng/l), p=0.03. Also the frequency of the troponin increase above the upper normal level in the nicorandal group, was significantly (p=0.03) lower (in 62% of cases compared to 85% of the control group). The conclusion. The protective effect of the oral form of nicorandil admission on the reduction of damage to cardiomyocytes during the elective PCI is a clinically proven effect of pharmacological preconditioning of this drug, which will expand the indications for its purpose in the strategy of drug support of PCI in patients with stable CHD.
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##article.viewOnOriginalSite##About the authors
R. V Gostishchev
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation
Email: gostiroman@gmail.com
аспирант отд. рентгенэндоваскулярных методов диагностики и лечения; Институт клинической кардиологии им. А.Л.Мясникова 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
G. N Soboleva
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federationд-р мед. наук, вед. науч. сотр. отд. ангиологии; Институт клинической кардиологии им. А.Л.Мясникова 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
A. N Samko
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federationд-р мед. наук, проф., рук. отд. рентгенэндоваскулярных методов диагностики и лечения; Институт клинической кардиологии им. А.Л.Мясникова 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
A. A Minasyan
A.L.Myasnikov Institute of Clinical Cardiology National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federationординатор; Институт клинической кардиологии им. А.Л.Мясникова 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
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