K. Weber et al., HEMODYNAMIC-EFFECTS OF NICORANDIL COMPARE D TO ISOSORBITOL-5-MONONITRATE IN PATIENTS WITH CORONARY HEART-DISEASE, Herz, Kreislauf, 28(12), 1996, pp. 381-386
Nicorandil is a potassium-channel opener in the therapy of coronary he
art disease. In addition to a nitrate-like effect, hyperpolarisation o
f the cell membrane by opening of potassium channels leads to relaxati
on of vascular smooth muscles. In a randomized, double-blind study in
30 patients with angiographically prooven coronary heart disease, effi
cacy of nicorandil (group 1) was compared to isosorbitol-5-mononitrate
(ISMN, group 2). Hemodynamics in rest and during exercise were measur
ed on the first day of treatment and in a subchronic phase (12 +/- 4 d
ays), each time immediately before and two hours after application. Re
sults: Main hemodynamic variables, i.e. diastolic pulmonary arterial p
ressure and mean pulmonary capillary pressure were decreased significa
ntly in both groups on the first day; there was no significant differe
nce between both substances. In both groups, a small, not significant
decrease of systolic and diastolic blood pressure was observed, heart
rate and cardiac index were not significantly changed. In subchronic p
hase, these results were confirmed. Conclusion: Nicorandil is a new su
bstance for the treatment of coronary heart disease with favourable he
modynamic effects comparable to nitrates. As it possesses a dual mecha
nism of drug action and lacking evidence for the development of a drug
-tolerance, nicorandil may demonstrate advantages compared to nitrates
.