The role of nicorandil in the treatment of myocardial ischaemia.
Nicorandil is an anti-anginal agent that has been used in the United Kingdom for over 6 years and is becoming increasingly popular. It induces coronary and peripheral vasodilatation via a dualistic mode of action, mediated by the opening of potassium-ATP channels (K(ATP)) and its nitrate effect by stimulation of adenyl cyclase, with an increase in cGMP levels. Comparison to nitrates and other anti-anginal agents have shown it to be of equal efficacy in relieving ischaemic symptoms. Recent evidence suggests a role for nicorandil as a myocardial preconditioning agent but this may be limited by systemic vasodilatation. There is ongoing research into its role in improving the long-term outcome of patients with ischaemic heart disease (IHD). It has been shown to be of proven efficacy in the treatment of IHD and further research will clarify other uses of this agent.
Falase
B
B
Department of Cardiothoracic Surgery, Morriston Regional Cardiac Centre, Morriston Hospital, Swansea, Wales, UK. Bodefalase@bigfoot.com
Easaw
J
J
Youhana
A
A
D000787:Angina Pectoris / Q000188:drug therapy; D000818:Animals; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D017202:Myocardial Ischemia / Q000188:drug therapy*; D020108:Nicorandil / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D015221:Potassium Channels / Q000187:drug effects; D020011:Protective Agents / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use*
D015221:Potassium Channels; D020011:Protective Agents; D014665:Vasodilator Agents; D020108:Nicorandil