Effects of nicorandil on endogenous fibrinolytic capacity in patients with coronary artery disease.
BACKGROUND
Nicorandil is a hybrid-type anti-anginal drug that combines a K(ATP) channel opener and a nitric oxide donor. Recently the IONA study reported that nicorandil improves the prognosis of patients with stable angina pectoris.


RESULTS
To examine the effects of nicorandil on endogenous fibrinolysis, plasma concentrations of tissue-type plasminogen activator (t-PA) antigen, type-1 plasminogen activator inhibitor (PAI-1) antigen and PAI activity were measured in consecutive 11 patients (7 men and 4 women, mean age 63 years, ranges 41-84 years) with coronary artery disease. Nicorandil (15 mg/day) was administered orally to each patient for 2 weeks. Venous blood samples were obtained from each patient before and after the administration of the drug in the early morning before eating. There were no significant changes in the plasma concentrations of t-PA (12.4+/-1.9 to 9.8+/-1.5) or PAI-1 (26.3+/-3.9 to 21.5+/-4.9) antigens (ng/ml, mean +/- SEM) before and after nicorandil administration. On the other hand, the plasma activity of PAI (IU/ml, mean +/- SEM) decreased significantly after the treatment (12.9+/-3.2 to 5.6+/-1.9, p=0.039).


CONCLUSIONS
It is well known that PAI activity determines the whole fibrinolytic capacity and oral administration of nicorandil decreased PAI activity in patients with coronary artery disease. This finding suggests that nicorandil improves the fibrinolytic capacity and may reduce the risk of coronary thrombus formation in such patients.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan. tom@kumamoto-u.ac.jp
Tomohiro
T
Sakamoto
Koichi
K
Kaikita
Shinzo
S
Miyamoto
Sunao
S
Kojima
Seigo
S
Sugiyama
Michihiro
M
Yoshimura
Hisao
H
Ogawa
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood; D020108:Nicorandil / Q000494:pharmacology* / Q000627:therapeutic use; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000097:blood*
D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D017395:Plasminogen Activator Inhibitor 1; D020108:Nicorandil; D010959:Tissue Plasminogen Activator