Authors : Alireza Rai, Mohammad Reza Saidi, Mansour Rezaei, Sara Jadbabaee, Hashem Kazerani, Amir Reza Ray and Parisa Janjani
Abstract: Nicorandil is a cardioprotective agent that improves anginal symptoms through dilatation of the coronary arteries as well as reduction of coronary vascular resistance. To assess the protective effects of short-term use of nicorandil on in-hospital outcome of patients with acute coronary syndrome. In a randomized double-blinded controlled trial, 240 patients suffered from typical chest pain and hospitalized with the final diagnosis of acute coronary syndrome infarction (NSTEMI) were included. The participants were randomly assigned to the intervention group receiving routine anti-thrombotic and anti-platelet drugs plus nicorandil 20 mg–1 bidorally 120 patients or control group receiving only routine cardiovascular drugs (120 patients). The severity of chest pain gradually reduced within 4 days of the study in both interventional and control groups but the decreasing trend in pain score was significantly more downward in former group. The prevalence rate of cardiac arrhythmias was 14.4% within a day after intervention that was significantly lower in intervention group than in control group (19.5 vs. 9.5%, p = 0.031). The occurrence rate of increase cardiac enzyme in the intervention and control groups was 9.9 and 29.7%, respectively with a significant difference (p<0.001). Also, the means level of cardiac enzymes including CK-MB and troponin T were initially lower in intervention group within the first day of assessment but remained similar in the next days. Regarding echocardiography indices, end-diastolic diameter was significantly lower in intervention group than in control group (47.4 vs. 49.7 mm, p = 0.034). Also, mitral insufficiency was significantly less prevalent in the former group (44.0 vs. 72.0%, p<0.001). No differences were observed in length of hospital stay or number of involved coronary arteries.
Alireza Rai, Mohammad Reza Saidi, Mansour Rezaei, Sara Jadbabaee, Hashem Kazerani, Amir Reza Ray and Parisa Janjani, 2015. Useful Clinical Effects of Short Term Consumption of Nicorandil on Early Outcome in Patients with Acute Coronary Syndrome. Research Journal of Medical Sciences, 9: 123-127.