Nicorandil as a treatment for stable angina

This study aimed to investigate the use of nicorandil (Ikorel) in coronary heart disease (CHD) patients who have stable angina.

This study concluded that using nicorandil with the standard antianginal therapy reduced the number of ischemic attacks in stable angina patients when compared to the standard antianginal therapy alone.  

CHD is caused by blockages of the coronary arteries that deliver blood to the heart. Blockages can be caused by plaque, a fatty substance that builds up in the blood vessels. Symptoms of CHD include heart attacks and angina. Angina is chest pain caused by the reduced flow of blood to the heart. Stable angina is the most common type and has a regular pattern. It can be predicted when the pain will occur. 

Nicorandil is a treatment that works to widen the coronary arteries that are narrowed by plaque build-up. Nicorandil can be used to treat angina. It is not clear whether this treatment decreases the risk of sudden blockages (ischemic attacks which can lead to heart attack) in all populations.

This study involved 402 patients with stable angina. 200 received standard antianginal treatment and nicorandil and 202 received standard antianginal treatment only (control group).  Patients were treated for a period of 12 weeks. The number of ischemic attacks were measured for both groups. Other factors were also measured.

The number of ischemic attacks after treatment was significantly lower in the nicorandil group and the control group. There were no differences between the nicorandil and control group in relation to other measures of heart function.

11.7% of the nicorandil group and 6.3% of the control group suffered at least one side effect while being treated during the study. The most common side effects associated with nicorandil were headache (13.1%) and nausea (2%).

This study concluded that patients with CHD and stable angina had a reduced number of ischemic attacks when nicorandil was used with a standard antianginal treatment in comparison to a standard antianginal treatment alone.  

The limitation to this study is that treatments were only carried out for 12 weeks. Further studies should include longer treatment periods.

This study was conducted in China. The effect of this treatment may be differen in other ethnicities. 

Nicorandil available in Europe, Asia, and Australia. It is not currently available in the United States.

Consult your physician about the pros and cons of nicorandil treatment.