The role of nicorandil in the treatment of myocardial ischaemia

Expert Opinion on Pharmacotherapy
B FalaseA Youhana

Abstract

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.

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Citations

Jul 15, 2004·Journal of Cardiovascular Electrophysiology·Zhifang YangYuanmou Liu
Aug 13, 2013·International Journal of Cardiology·Sayed NourGuifu Wu
Jun 18, 2016·Cardiovascular Drugs and Therapy·Jason M Tarkin, Juan Carlos Kaski
Jul 6, 2018·Current Atherosclerosis Reports·Ahmadreza Karimianpour, Anbukarasi Maran
Dec 14, 2019·Indian Journal of Pharmacology·Lamiaa Ahmed Ahmed

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