OBJECTIVE
To assess clinical efficacy of nicorandil at a dose of 20 mg daily in preoperative period and its impact on the quality of life and postoperative outcomes in patients with stable coronary artery disease (CAD) scheduled for coronary artery bypass grafting (CABG).
MATERIAL AND METHODS
We examined 60 patients aged 62.4 [58; 67] years with stable exertional angina before elective isolated on-pump CABG. Patients were randomized into 2 groups. In the main group (n=30), nicorandil (Kordinik, PIK-PHARMA) was prescribed at a dose of 20 mg per day for 1—2 months until the day of surgery in addition to standard therapy of CAD. In the control group (n=30), nicorandil was not prescribed in preoperative period. Target parameters were assessed at initial visit to the cardiologist, 1—2 months later at admission to the hospital for CABG and after 7—10 postoperative days. Class of angina pectoris was also assessed prior to surgery in comparison with that at initial examination. Quality of life was were estimated at initial examination and after 7—10 postoperative days using SF-36 questionnaire. Incidence and structure of postoperative in-hospital complications were analyzed. Statistical analysis was performed using Statistica 10.0 software package («Statsoft», USA).
RESULTS
At initial visit, patients of both groups were similar by clinical and anamnestic characteristics, age and men-to-women ratio. No differences were found in quality of life. After 1—2 months, 20% of patients in the main group had angina class 0-I that was significantly more compared to baseline data (p=0.02). Only 13.3% of patients had no clinical improvement (angina class III). In the control group, severity of angina pectoris was the same compared to initial class. There was lower incidence of early postoperative complications in the main group (36%) compared to the control group (50%) (p>0.05). In the control group, postoperative physical health was significantly worse compared to baseline data (p=0.003). In the main group, there were no significant changes in quality of life.
CONCLUSION
We observed better preoperative course of CAD in patients who received nicorandil. Addition of nicorandil in preoperative period is valuable to optimize the quality of life and course of early postoperative period.
