The effect of intracoronary nicorandil on coronary myocardial bridging

Jae Hun Jung, Pil Ki Min, Chong Won Sung, Sang Hak Lee, Seonghoon Choi, Jung Rae Cho, Namho Lee, Kyoung Ha Park, Min Kyu Kim, Woo Jung Park, Yangsoo Jang

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Abstract

Medical treatments of coronary myocardial bridging (CMB) generally include ?2-blockers and calcium channel blockers. Nitrates are avoided because symptoms may worsen. Nicorandil is a hybrid of a nitrate and a potassium channel opener. However, the effect of nicorandil on CMB is unknown. We analyzed nicorandil reactivity at the site with CMB in 51 patients. Maximal and minimal diameters of CMB were measured by quantitative angiography at baseline and at 60 seconds after intracoronary administration of 200 mg nicorandil. The maximal diameter during diastole increased from 2.15 + 0.42 mm to 2.34 + 0.44 mm after administration of nicorandil (P <.001), and the minimal diameter during systole increased from 1.24 + 0.63 mm to 1.67 + 0.64 mm (P <.001). Thus, nicorandil reduced the percentage vessel narrowing from 44.0 + 26.1% to 30.3 + 21.2% (P <.001). In 22 patients, we also evaluated the effect of nitroglycerin. The maximal diameter during diastole increased from 2.25 + 0.47 mm to 2.51 + 0.44 mm after administration of nitroglycerin (P <.019), and the minimal diameter during systole decreased from 1.28 + 0.64 mm to 1.14 + 0.60 mm (P =.276). Thus, nitroglycerin augmented the percentage vessel narrowing from 44.9% + 25.0% to 56.0% + 23.5% (P =.023). These results indicate that intracoronary administration of nicorandil could dilate coronary arteries during diastole as well as systole in patients with CMB during coronary angiography.

Original languageEnglish
Pages (from-to)180-184
Number of pages5
JournalJournal of Cardiovascular Pharmacology and Therapeutics
Volume14
Issue number3
DOIs
Publication statusPublished - 2009 Sep 1

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All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

Cite this

Jung, J. H., Min, P. K., Sung, C. W., Lee, S. H., Choi, S., Cho, J. R., Lee, N., Park, K. H., Kim, M. K., Park, W. J., & Jang, Y. (2009). The effect of intracoronary nicorandil on coronary myocardial bridging. Journal of Cardiovascular Pharmacology and Therapeutics, 14(3), 180-184. https://doi.org/10.1177/1074248409338930