Efficacy and safety of nicorandil monotherapy and nicorandil-clopidogrel combination therapy on cardiac function in patients with coronary heart disease.

OBJECTIVES

To compare the efficacy and safety of nicorandil monotherapy and nicorandil-clopidogrel combination therapy on cardiac function in patients with coronary heart disease (CHD).

METHODS

The clinical data of 200 patients with CHD were retrospectively analyzed. The patients were divided into two groups according to different treatment methods. Group A (n = 100) received nicorandil-clopidogrel combination therapy (intravenously injected with 25 mg of nicorandil and orally administered 300 mg of clopidogrel for 3 months), and Group B (n = 100) received nicorandil monotherapy (intravenously injected with 25 mg of nicorandil for 3 months). The primary endpoints included cardiac function indices and ST-segment behavior on electrocardiogram (ECG) before and after treatment. The secondary endpoints included adverse reactions, clinical efficacy, platelet aggregation, activated partial thromboplastin time (APTT), high-sensitivity cardiac troponin T (hs-cTnT), and creatine kinase isoenzyme MB (CK-MB) levels after treatment. Multivariate regression analyses were used to assess the contribution of a single drug to the ultimate outcome.

RESULTS

After treatment, both groups exhibited significant decreases in brain natriuretic peptide (BNP) and N-terminal pro-hormone BNP levels compared with before treatment, with the levels significantly lower in Group A than in Group B ( < 0.05). After treatment, left ventricular ejection fraction was significantly increased in both groups compared with before treatment, and that was much higher in Group A than in Group B ( < 0.05). After treatment, the frequency and duration of ST-segment depression were decreased in both groups compared with before treatment, and they were much lower in Group A than in Group B (all < 0.05). The total incidence of adverse reactions in Group A (4.00%) was slightly lower than that in Group B (7.00%), with no significant difference ( > 0.05). Group A (92.00%) had a higher overall response rate than Group B (81.00%) ( < 0.05).

CONCLUSION

Nicorandil-clopidogrel combination therapy exhibited enhanced clinical efficacy in patients with CHD. In addition, the combination therapy regulated hs-cTnT and CK-MB levels, which may suggest a better patient prognosis.