Effects of nicorandil infusion on ECG parameters in patients with unstable angina pectoris and percutaneous coronary intervention

Ann Noninvasive Electrocardiol. 2020 Jul;25(4):e12736. doi: 10.1111/anec.12736. Epub 2019 Dec 17.

Abstract

Background: Percutaneous coronary intervention (PCI) is effective in treating patients with acute coronary syndrome (ACS) but is associated with some serious complications. Nicorandil is an anti-anginal agent acting to improve microvascular circulation and to increase coronary blood flow. The objective of this article is to evaluate the effects of intracoronary injection followed with continuous intravenous injection of nicorandil on ECG parameters in patients with unstable angina pectoris (UA) undergoing PCI.

Methods: A single-center, self-controlled clinical trial was conducted at the Second Hospital of Tianjin Medical University between January 2019 and April 2019. Sixty-three consecutive patients with UA who received coronary angiography and selective PCI were enrolled. ECG was recorded and analyzed before and 24 hr after nicorandil infusion.

Results: Patients were divided into three groups: control group (n = 23, aged 63.43 ± 12.55 years), short-term, and prolonged use with nicorandil group (n = 20 and 20, aged 66.45 ± 8.06 years and 65.80 ± 9.49 years, respectively). Clinical characteristics and ECG parameters were similar before PCI among three groups (p > .05). In nicorandil treatment groups, intervals of QTd and Tp-e in patients post-PCI were significantly shorter than that in control and pre-PCI (p < .05).

Conclusions: Nicorandil infusion reduces QTd and Tp-e interval in patients with UA. Further studies will be needed to determine whether these electrophysiological changes are associated with a reduction of ventricular arrhythmias and improved outcomes.

Keywords: QT dispersion; Tp-e interval; nicorandil; unstable angina pectoris.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angina, Unstable / drug therapy
  • Angina, Unstable / physiopathology
  • Angina, Unstable / therapy*
  • Electrocardiography / drug effects*
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Nicorandil / pharmacology*
  • Percutaneous Coronary Intervention / methods*
  • Treatment Outcome
  • Vasodilator Agents / pharmacology*

Substances

  • Vasodilator Agents
  • Nicorandil