Nicorandil Improves Left Ventricular Myocardial Strain in Patients With Coronary Chronic Total Occlusion

Shaomin Chen, Chen Ma, Xinheng Feng, Ming Cui, Shaomin Chen, Chen Ma, Xinheng Feng, Ming Cui

Abstract

Background: Nicorandil is recommended as a second-line treatment for stable angina; however, randomized-controlled trials to evaluate the benefit of nicorandil for patients with chronic total occlusion (CTO) are lacking.

Objective: To determine whether nicorandil can improve left ventricular (LV) myocardial strain in patients with CTO.

Methods: Patients with CTO were included and randomized to the nicorandil group (n = 31) and the control group (n = 30). Nicorandil was given orally at 15 mg/day for 3 months in the nicorandil group. Three-dimensional speckle-tracking echocardiography and the Seattle Angina Questionnaire (SAQ) survey were performed at baseline and at 3 months. The primary study endpoint was the LV global area strain (GAS) at 3 months.

Results: The nicorandil and the control groups were well-matched at baseline, including the mean GAS and SAQ scores. At 3 months, GAS in the nicorandil group was significantly higher than that in the control group (-23.7 ± 6.3% vs. -20.3 ± 5.6%, respectively; p = 0.033). There were no significant differences in LV global longitudinal strain, global circumferential strain, global radial strain, LV ejection fraction, LV end-diastolic volume, and LV end-systolic volume at 3 months between the two groups. At 3 months, the SAQ scores for angina stability, angina frequency, and treatment satisfaction in the nicorandil group were significantly higher than those in the control group.

Conclusion: Nicorandil treatment can improve GAS and angina symptoms in patients with CTO.

Clinical trial registration: www.ClinicalTrials.gov, identifier: NCT05087797.

Keywords: chronic total occlus; coronary heart disease; global area strain; nicorandil; speckle tracking echocardiograph.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Chen, Ma, Feng and Cui.

Figures

Figure 1
Figure 1
Patient flow chart. CABG, coronary artery bypass grafting; CTO, chronic total occlusion; PCI, percutaneous coronary intervention.
Figure 2
Figure 2
Comparison of GAS between the nicorandil group and the control group. GAS, global area strain.
Figure 3
Figure 3
Comparison of seattle angina questionnaire scores between the nicorandil group and the control group.

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