Introduction: Nicorandil, combination of nitrate com-ponent and sarcolemma adenosine triphosphate-sensi-tive potassium channel opener, is a potent vasodilator of coronary and peripheral vessels and has been used as an antianginal agent, but its effect in heart failure (HF) patients has not been fully established. Therefore, we examined impacts of nicorandil in ischemic HF pati-ents in a small cohort.
Objective: To assess the efficacy of therapy with nico-randil in hospitalized with ischemic chronic heart fai-lure.
Methods: A small cohort of patients with heart failure of ischemic etiology were prospectively registered and divided into 2 groups based on oral administration of nicorandil: nicorandil group (n=6) and non-nicorandil group (n=6). All patients received also standard treat-ment for HF (betablockers, mineralocorticoids, diu-retics and angiotensin-converting enzyme inhibitors). Patients were randomly assigned to be treated with or without oral nicorandil, 10 mg twice daily for 5 days. BNP values were measured at admission and at 5th day. We assessed BNP levels, echocardiographic measure-ments, and number of days until first readmission for each group.
Results: 66.6% of the patients were men, mean age was 67 years and mean length of inpatient stay was 7.8 days. We found a positive correlation between initial BNP and the number of hospitalized days in nicorandil group (r=0.64) and a negative correlation between ini-tial BNP and the number of hospitalized days in non-nicorandil group (r=-0.73). The difference between levels of BNP after 5 days of treatment and initial BNP in the two groups is statistically significant (p=0.038). We did not found statistically significant differences between the two groups regarding number of days of hospitalization (p=0.44). There was a negative correla-tion between MAPSE and the number of days before the first reinstatement.
Conclusions: The patients in the nicorandil group had higher decrease of BNP levels without shortening the length of hospitalization. Further studies with larger cohorts are needed.