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Clinical Trial on Unstable Angina Pectoris Treated with Nicorandil

Author: HanXiao
Tutor: ZhengLiWen
School: Yanbian University
Course: Internal Medicine
Keywords: Coronary heart disease Unstable angina Nicorandil Nitroglycerin
CLC: R541.4
Type: Master's thesis
Year: 2010
Downloads: 60
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Abstract

With the improvement of people's living and lifestyle changes, more and more of the incidence of coronary heart disease in the crowd, especially with unstable angina (UA) increasing the number of patients, because of the high incidence of high mortality rate gave rise to a great deal of energy and financial resources of the burden of scholars at home and abroad has aroused widespread concern. Unstable angina is a type of coronary heart disease serious condition, between stable angina pectoris (SAP) and acute myocardial infarction (Acute Myocardial Infarction AMI) between a group of clinical angina syndrome, easily the development of acute myocardial infarction or cardiac sudden death. Early and correct clinical treatment for patients with unstable angina, reduce or avoid the occurrence of acute myocardial infarction and sudden cardiac death one of the important part of. In recent years, nicorandil as a drug for the treatment of unstable angina in clinical practice has been widely applied, the 2006 European Society of Cardiology angina guide that nicorandil can be used as a level I recommended drug treatment to improve the symptoms of angina, but as potassium channel opener used in unstable angina rarely reported. This article by the People's Liberation Army No. 208 Hospital of Cardiology, from January 2008 to November 2009 with complete clinical data of 116 cases of hospitalization for unstable angina patients to take a different way application of nicorandil and intravenous nitroglycerin, follow-up and review study. Comprehensive analysis of nicorandil clinical efficacy for the treatment of unstable angina, how to scientifically clinical application of nicorandil provide an objective scientific basis for the treatment of unstable angina. Objective: To investigate the different route of administration applications nicorandil clinical efficacy for the treatment of unstable angina, and compare the clinical efficacy of intravenous and oral nicorandil with intravenous nitroglycerin of. Methods: A retrospective analysis of 116 cases from January 2008 to November 2009 in our hospital cardiovascular medical inpatients. All patients meet the diagnostic criteria for unstable angina diagnosis and treatment recommendations, were randomly divided into three groups: oral nicorandil group (n = 51) of intravenous nicorandil group (n = 34) and venous injection of nitroglycerin group control group (n = 31), respectively, between the different groups from the following aspects are compared: age, before treatment Braunwald classification, improved the incidence of angina, ischemic electrocardiographic improve the incidence of follow-up 6 months within the incidence of cardiovascular events, the incidence of adverse reactions. Results: oral nicorandil group, intravenous nicorandil group and control group three groups of patients age, no significant difference before treatment Braunwald classification in each group were comparable. Oral nicorandil group, angina improvement in the incidence of intravenous nicorandil group and control group after treatment: oral nicorandil group was 58.8% (30/51)%; intravenous nicorandil group 61.7% (21/34); nitroglycerin group was 35.4% (11/31). Angina improvement of the of oral nicorandil group with intravenous nicorandil group the incidence of p gt; 0.05), the difference was not statistically significant, oral nicorandil group and nitroglycerin group angina improvement in the incidence of (p lt; 0.05), the difference was statistically significant, the incidence of angina improvement of intravenous nicorandil group and the nitroglycerin group (p lt; 0.05), the difference was statistically significant. Oral nicorandil group, intravenous nicorandil group and control group were resting ECG to improve efficiency: oral nicorandil group was 11.7% (6/51); intravenous nicorandil group 14.7% (5/34); nitroglycerin group was 9.6% (3/31). Oral nicorandil group with intravenous nicorandil Seoul group after treatment the first day resting ECG improved efficiency (p GT; 0.05), the difference was not statistically significant, oral nicorandil group and nitric acid glycerol group of medication the first day after the resting ECG to improve efficiency comparison (p gt; 0.05), the difference was not statistically significant, of intravenous nicorandil group of medication nitroglycerin group after the first day resting ECG improvement more efficient (p gt; 0.05), the difference was not statistically significant. 7th day resting ECG improvement after treatment efficiency, oral nicorandil group was 27.4% (14/51); and intravenous nicorandil group was 29.4% (10/34; nitroglycerin group 6.4% (2/31); oral nicorandil group with the intravenous the nicorandil group of medication on the 7th day after resting ECG improved efficiency (p gt; 0.05), the difference was not statistically significant , the of oral nicorandil group with nitroglycerin medication after the 7th day resting ECG improve efficiency comparison (p lt; 0.05), the difference between the two groups was statistically significant, the of intravenous nicorandil group with nitroglycerin medication 7th day after the resting ECG improved efficiency comparison (p lt; 0.05), the difference was statistically significant, the 14th day resting ECG after administration to improve efficiency, oral nicorandil group 31.3% (16/51); intravenous nicorandil group was 35.2% (12/34); nitroglycerin group was 9.6% (3/31). oral nicorandil group and intravenous nicorandil the group resting electrocardiogram on the 14th day after treatment to improve the efficiency (p gt; 0.05), the difference was not statistically significant, improvement in oral nicorandil group with nitroglycerin medication after 14 days resting ECG efficient comparison (p lt; 0.05), the difference between the two groups was statistically significant, and 14 days after administration of intravenous nicorandil group and nitroglycerin group resting ECG to improve efficiency (p lt; 0.05) The difference was statistically significant. oral nicorandil group, of intravenous nicorandil Seoul group and the control group three groups of patients were followed up for the incidence of cardiovascular events within 6 months. oral nicorandil group was 3.9% (2 / 51); intravenous nicorandil group was 2.97% (1/34); nitroglycerin group was 3.2% (1/31) showed no significant difference among the three groups in the three groups the proportion of adverse reactions occurred as follows : oral nicorandil group, intravenous nicorandil Seoul group and control group, three groups of patients the incidence of adverse reactions was 13.7% (7/51): oral nicorandil group; intravenous nicorandil group 14.7% (5/34); the nitroglycerin group 16.1% (5/31) among the three groups (p GT; 0.05), the difference was not statistically significant. Conclusions: 1. different route of administration (intravenous, oral ) the application of nicorandil in controlled clinical symptoms of angina and improve ECG aspects can get good clinical efficacy, and are superior to nitroglycerin. 2 different routes of administration (intravenous, oral) application of nicorandil to reduce near-term heart There was no significant difference in vascular events. nicorandil has a good safety, adverse reactions, especially in hypotension was significantly lower than nitroglycerin.

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