Clinical Study On The Immediate Effect Of Nicorandil On Coronary Slow Flow

Objective:Coronary slow flow phenomenon is a special kind of coronary microvascular disease,its mechanism is not clear and the treatment is limited.In this study,the immediate effect of nicorandil on CSFP was observed by the method of intracoronary nicorandil,the changes of the number of frames in the end of the injection were observed before and 1,3,5,10 minutes after injection.Methods: A total of 56 patients with CSFP confirmed by coronary angiography were selected from October 2014 to December 2016,in the Department of Cardiology of the Third Hospital of Hebei Medical University.Coronary slow flow phenomenon defined as the contrast agent can not reach the end of the vessel in three cardiac cycles.The patients were randomly divided into two groups according to the mating number of the hospital.The number of the maternity was the experimental group,and the odd number was listed as the control group.The test group of 36 patients were enrolled in the coronary arteries by intravenous injection of nicorandil 2 mg(4 mg/min).The coronary blood flow was quantitatively evaluated by TIMI frame count.The intracoronary TFC values were recorded before and 1 min,3 min,5 min,10 min after administration.A total of 20 patients in the control group were injected with 200?g of nitroglycerin(400?g/min)in coronary artery by coronary angiography catheter.The changes of TFC values were observed by the same method.The heart rate,systolic and diastolic blood pressure of the two groups before and after administration were recorded.Results:1 Basic data:The clinical characteristics of the two groups of patients were similar,the difference was not statistically significant.2 Nicorandil was used in the coronary arteries of LAD,RCA and LCX inthe test group.The TFC was the lowest at 1 minute after administration,and there was significant diffwas erence comparing with 3 minutes,5 minutes,10 minutes after administration and before administration(P < 0.001).In the control group,nitroglycerin was used in the LAD coronary arteries,and the TFC was the lowest at 1 minute after administration.There a significant difference comparing with 3 minutes,5 minutes,10 minutes after administration and before administration(P <0.001).In the control group,LCX and RCA coronary artery were applied with nitroglycerin,and the TFC value was the lowest at 1 minutes.There was no significant difference between before and 1,3,5,10 minutes after administration(P > 0.05).The reduction of percentage of TFC in the test group was significantly higher than that in the control group,after the injection of drugs at 1 minute,in LAD,LCX coronary artery(P < 0.05).There was no significant difference in the reduction of percentage of TFC between test group and the control group in the right coronary artery at 1 minute(P > 0.05).3 Changes of heart rate and blood pressure before and after administration in two groups:There were no significant changes in heart rate before and after injection of nicorandil at 1,3,5,10 minutes.The heart rate was highest at 1 minutes after injection of nitroglycerin in the control group.The systolic blood pressure and diastolic blood pressure were the lowest at 1minutes after administration of drugs in two groups.Conclusions:1 Both intracoronary nicorandil and nitroglycerin can improve TFC in CSFP.2 The immediate effect of intracoronary nicorandil is better than nitroglycerin in CSFP.3 The effect of intracoronary nicorandil was the most obvious at 1 minute and the TFC restored to the preoperative level at 5 minutes.