A study of the impact of nicorandil on coronary microcirculation dysfunction and myocardial perfusion reserve in pa-tients with obstructive coronary heart disease

Huang Lie; Liu Lei; Yang Chunhong; Wang Yanlin; Diao Mingrui; Deng Shiwu

doi:10.3969/j.issn.1671-6450.2026.02.005

Abstract：Objective To investigate the impact of nicorandil on coronary microcirculation dysfunction and myocar-dial perfusion reserve in patients with obstructive coronary heart disease(OCHD).Methods A total of 178 patients with OCHD admitted to our hospital from January 2022 to December 2024 were selected and divided into two groups,with 89 ca-ses in each group.The control group received conventional basic treatment,while the study group received nicorandil in addi-tion to the treatment given to the control group.The differences in clinical efficacy,coronary microcirculation dysfunction,my-ocardial perfusion reserve,cardiac function,and adverse reactions between the two groups were compared.Results The clini-cal efficacy of the study group was significantly higher than that of the control group(x2=4.773,P＜0.05).Repeated-measures analysis revealed significant time,between-group,and interaction effects for distal coronary pressure(Pd),index of microcircu-latory resistance(IMR),myocardial blood flow,blood flow velocity,transmural myocardial perfusion reserve index(transmural MPRI),peak myocardial signal intensity,maximum upslope rate of first-pass perfusion,N-terminal pro-B-type natriuretic pep-tide(NT-proBNP),creatine kinase-MB(CK-MB),and cardiac troponin I(cTnI)in both groups(P＜0.05).For the time to peak of first-pass perfusion,significant time and interaction effects were observed in both groups(P＜0.05).After the intervention,the time to peak of first-pass perfusion,Pd,IMR,NT-proBNP,CK-MB,and cTnI were significantly reduced,while the trans-mural MPRI,peak myocardial signal intensity,maximum upslope rate of first-pass perfusion,myocardial blood flow,and blood flow velocity were significantly increased.The magnitude of these changes was greater in the study group than in the control group(t=12.968,26.790,108.735,91.296,146.835,426.022,42.097,121.478,36.722,56.127,14.070,respectively;P＜0.05).No statistically significant difference was observed in the incidence of adverse reactions between the two groups(x2=0.097,P＞0.05).Conclusion Nicorandil has a significant therapeutic effect on patients with OCHD.It can effectively improve coronary microcirculation dysfunction,enhance myocardial perfusion reserve,reduce the levels of myocardial injury markers,and does not increase the incidence of adverse reactions during the treatment process,demonstrating good safety.