OBJECTIVE

To assess the effect of nicorandil on the the outcomes of vascular surgeries and the high-sensitivity cardiac troponin (hs-cTn) level in the early postoperative period in patients with stable coronary heart disease (CHD).

MATERIAL AND METHODS

The study included 50 patients with class II—III stable angina pectoris who would undergo femoral-popliteal bypass (FPB). All patients were randomized into two equal groups: a control group — 25 patients, and a study group — 25 patients, who were prescribed nicorandil (Cordinic, PIQ-Pharma company) 2 hours before the surgery in addition to the basic therapy with the maximum single dose 20 mg. In the postoperative period we assessed the frequency and the structure of cardiovascular complications (CVC) including myocardial damage by the dynamics of the hs-cTn rising. The obtained primary data were mathematically processed using Statistica 10.0 software and SAS 9.3 software package.

RESULTS

At baseline, the study nicorandil group and the control group were comparable in terms of clinical characteristics, basic medical therapy and duration of surgery. In the nicorandil group there was no increase of hs-cTn. At the same time in the standard therapy group there were 4 cases with the level of hs-cTn above certain threshold values in 24 hours after surgery, which indicated intraoperative myocardial damage (0% vs. 16%, p=0.110). The statistical significance of intergroup differences was obtained by assessing the overall frequency of CVC (myocardial infarction and damage, the development of heart failure and rhythm disturbances) in the study nicorandil group and the control group (8% vs. 36%, respectively, p=0.037).

CONCLUSION

The use of nicorandil (Cordinic, PIQ-Pharma company) before open arterial reconstruction leads to a decrease in the level of hospital adverse cardiac events and myocardial damage in the early postoperative period, that is determined by the dynamics of hs-cTn.