Pingul, Maria Charline A.

BSN III- C

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✓ Effects of nicorandil infusion on ECG parameters in patients with unstable angina

pectoris and percutaneous coronary intervention
✓ Weiding Wang MD, PhD | Xu Zhang BS | Kangyin Chen MD, PhD | Li Yin MD,
PhD | Mengqi Gong BS| Yang Liu BS | Gary Tse MD, PhD | Lin Wu MD, PhD, |
Guangping Li MD, PhD | Tong Liu MD, PhD
✓ Date of acceptance: 19 November 2019
✓ Date of submission:19 September 2019
✓ Publication: 17 December 2019”
✓ DOI: 10.1111/anec.12736

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”The main problem aims to determine the effects of nicorandil infusion on ECG
parameters in patients with unstable angina pectoris and percutaneous coronary
intervention. Plaque, a waxy material that forms inside the lining of major coronary
arteries, is a common cause of coronary heart disease. Coronary heart disease (CHD)
is caused by atherosclerosis, which results in stenosis or blockage of the coronary
arterial lumen, resulting in myocardial ischemia, angina pectoris, and/or infarction.
Despite the fact that worldwide CHD mortality has declined in recent years, the
prevalence of CHD has continued to grow rapidly, especially in developing countries
(Ebrahim & Smith, 2001)”
 “Nicorandil is a nitric oxide donor and an ATP-dependent potassium channel
opener that is used to alleviate ischemia symptoms in individuals with coronary artery
disease. By opening the K+-ATP channels in vascular smooth muscle cells, it
promotes K+ efflux and reduces Ca2+ influx. As a result, cells are freed of excess
calcium, which has been related to a decreased risk of arrhythmias. It can help relax
small coronary arteries and increase blood flow to the heart muscle.”

“Percutaneous coronary intervention (PCI) is an efficient treatment for acute

coronary syndrome (ACS); however, it is associated with certain serious effects.
Nicorandil is an anti-anginal medication that enhances coronary artery microvascular
circulation and blood flow”

“The study aims to see to see how PCI patients with unstable angina pectoris (UA)
respond to intracoronary injection followed by continuous intravenous nicorandil
injection. In addition, a few studies have examined the effect of intracoronary injection
associated with process intravenous nicorandil injection on ECG parameters in clients
with instability angina pectoris (UA) who underwent PCI.”

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“Between January and April 2019, Tianjin Medical University's Second Hospital
performed a single-center, self-controlled clinical research. The research comprised
63 patients with UA who had coronary angiography and selective PCI. A standard 12-
lead ECG was obtained and assessed before and after nicorandil infusion, as well as
24 hours afterwards. The study was conducted in line with the Declaration of Helsinki,
was authorized by the hospital's medical council, and participants' permission was
obtained.”

“The following were among the exclusion criteria for this study: (a) history of
myocardial infarction; (b) complete left or right bundle branch block; (c) atrial flutter
or fibrillation; (d) acute heart failure; (e) history of ventricular pacemaker implantation;
(f) severe liver and renal insufficiency or electrolyte abnormalities; (g) complications
during angioplasty (acute stent thrombosis, coronary dissect); (h) those already
using nicorandil (i) hx of coronary artery bypass grafting (CABG) ”
 “All of the participants had routine blood testing and echocardiography. To treat
their unstable angina and other illnesses, all of the individuals were given their normal
medications. The data was statistically evaluated using IBM SPSS version 19
software. Matching t tests were used to compare differences in the same group
before and after therapy. A statistically significant difference was defined as a
difference of p.05, and proportions were compared using the chi-square or Fisher's
exact tests.”

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“The research included a total of 63 patients with UA who had had coronary
angiography and selective PCI. In terms of age, sex, smoking and drinking history,
comorbidities, laboratory blood test results, and echocardiographic parameters,
there were no differences between the three groups. QTd and Tp-e intervals in
patients post-PCI in the nicorandil therapy groups were substantially shorter than in
control and pre-PCI patients (p.05).”

“Nicorandil infusion reduces QTd and Tp-e intervals in people with UA. More study
is needed to determine if these electrophysiological changes are connected to a
reduction in ventricular arrhythmias and improved outcomes.”

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“The study's main finding was that nicorandil decreased repolarization dispersion,
also known as QT dispersion and Tp-e intervals, in both short and long-term usage,
suggesting that nicorandil's cardioprotective benefits are at least partially reflected
in these parameters (Qi et al., 2018; Takabatake et al., 2015). Intracoronary
nicorandil injection did not produce the expected therapeutic effect, according to Wu,
Huang, Xie, and Zhou (2013), which could be due to the drug's short half-life. After
intracoronary short-term usage of nicorandil, a continuous intravenous infusion of
the medication was done in this trial.”
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“As future nurses, we have certain responsibilities and behaviors to follow. One of
them is acting as a role model for others who are now experiencing cardiac issues.
We must give precise directions to family, friends, and patients that they can follow.
Furthermore, we may provide particular preventative information to our patients,
such as how to manage risk factors such as hypertension and obesity.”

“Another method is to stay active and exercise to help lower cholesterol unless
activities trigger chest pains then activity should be minimized and regulated.
Doctors' prescriptions for heart medications should be followed as ordered as this
can help prevent symptoms of heart diseases including angina pectoris.
Furthermore, the patient should be taught the importance of not dismissing or
ignoring angina episodes and reporting them to a healthcare provider as soon as
possible. Finally, we can always rely on the adage that prevention is better than
cure, therefore we must take preventative steps as soon as possible to avoid heart
diseases.”