Effects of nicorandil combined with atorvastatin on vascu-lar endothelial function,blood lipids,and inflammatory factors in coronary heart disease patients with myocardial ischemia

LU Cheng-bin

doi:10.3969/j.issn.1009-8933.2025.04.010

Abstract：Background Coronary heart disease with myocardial ischemia is closely associated with vascular endothelial dysfunction, dyslipidemia, and chronic inflammatory response. Atorvastatin, a classic lipid-lowering agent, exhibits pleiotropic effects including plaque stabilization, endothelial function improvement, and anti-inflammatory actions. Nicorandil, as a potassium channel opener with additional nitrate-like effects, directly dilates coronary arteries and improves myocardial microcirculation. Theoretically, the two drugs may synergistically enhance myocardial perfusion and endothelial function through distinct mechanisms. However, clinical evidence regarding the comprehensive impact of their combination on vascular endothelial function, blood lipid profiles, and systemic inflammatory status in patients with coronary heart disease and myocardial ischemia remains insufficient. Further studies are warranted to clarify their synergistic effects and clinical value. Methods A total of 60 patients with coronary heart disease and myocardial ischemia admitted to our hospital from January 2023 to October 2024 were enrolled and randomly divided into combination group and control group using a random number table, with 30 patients in each group. The control group received atorvastatin treatment, while the combination group received nicorandil combined with atorvastatin. After 12 weeks of continuous treatment, the clinical efficacy, vascular endothelial function, blood lipid profiles, inflammatory factors, and adverse reactions were compared between the two groups. Results The total effective rate in the combination group (93.33%) was significantly higher than that in the control group (70.00%) (P < 0.05). After treatment, serum endothelin (ET) level was lower in the combination group than in the control group (P < 0.05), while nitric oxide (NO) level was higher (P < 0.05). In the combination group, the levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were all lower than those in the control group (P < 0.05), while high-density lipoprotein cholesterol (HDL-C) level was higher (P < 0.05). Levels of C-reactive protein (CRP), interleukin (IL)-8, and IL-6 in the combination group were also lower compared with the control group (P < 0.05). No significant difference was observed in the incidence of adverse reactions between the two groups (P > 0.05). Conclusions The combination of nicorandil and atorvastatin demonstrated certain short-term therapeutic effects in patients with coronary heart disease and myocardial ischemia. It not only effectively improves vascular endothelial function and regulates lipid metabolism but also suppresses the levels of inflammatory factors, with a favorable safety profile. [S Chin J Cardiol 2025;26(4):292-299]