The effect of intracoronary nicorandil on coronary myocardial bridging.

Abstract

Medical treatments of coronary myocardial bridging (CMB) generally include beta-blockers and calcium channel blockers. Nitrates are avoided because symptoms may worsen. Nicorandil is a hybrid of a nitrate and a potassium channel opener. However, the effect of nicorandil on CMB is unknown. We analyzed nicorandil reactivity at the site with CMB in 51 patients. Maximal and minimal diameters of CMB were measured by quantitative angiography at baseline and at 60 seconds after intracoronary administration of 200 mg nicorandil. The maximal diameter during diastole increased from 2.15 + 0.42 mm to 2.34 + 0.44 mm after administration of nicorandil (P < .001), and the minimal diameter during systole increased from 1.24 + 0.63 mm to 1.67 + 0.64 mm (P < .001). Thus, nicorandil reduced the percentage vessel narrowing from 44.0 + 26.1% to 30.3 + 21.2% (P < .001). In 22 patients, we also evaluated the effect of nitroglycerin. The maximal diameter during diastole increased from 2.25 + 0.47 mm to 2.51 + 0.44 mm after administration of nitroglycerin (P < .019), and the minimal diameter during systole decreased from 1.28 + 0.64 mm to 1.14 + 0.60 mm (P = .276). Thus, nitroglycerin augmented the percentage vessel narrowing from 44.9% + 25.0% to 56.0% + 23.5% (P = .023). These results indicate that intracoronary administration of nicorandil could dilate coronary arteries during diastole as well as systole in patients with CMB during coronary angiography.

• Authors: Jae-Hun Jung, Pil-Ki Min, Chong Won Sung, Sang-Hak Lee, Seonghoon Choi, Jung Rae Cho, Namho Lee, Kyoung-Ha Park, Min-Kyu Kim, Woo Jung Park, Yangsoo Jang
• Journal: Journal of cardiovascular pharmacology and therapeutics (J Cardiovasc Pharmacol Ther) Vol. 14 Issue 3 Pg. 180-4 (Sep 2009) ISSN: 1074-2484 [Print] United States
• PMID: 19605572 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Vasodilator Agents
• Nicorandil

Topics

• Coronary Angiography
• Coronary Vessels (drug effects, physiopathology)
• Female
• Humans
• Male
• Middle Aged
• Myocardial Bridging (diagnostic imaging, drug therapy, physiopathology)
• Nicorandil (administration & dosage)
• Prospective Studies
• Treatment Outcome
• Vasodilation (drug effects)
• Vasodilator Agents (administration & dosage)