Медицинский совет (Jan 2019)
Possibilities of nicorandil for coronary insufficiency correction in patients with ischemic heart disease and diabetes mellitus type 2
Abstract
Cardiovascular complications of type 2 diabetes mellitus (T2DM) are now a global health problem, due to their main cause of mortality of these patients. Ischemic heart disease (IHD) among all cardiovascular diseases occupies a leading position. The purpose of the study was comparative assessment of possibilities of coronary reserve correction in patients with stable angina and T2DM by nitrates and activator of potassium channels by nicorandil. The study included 54 patients with stable angina of 2-3 functional classes (FC) and T2DM. The dynamics of frequency of angina attacks, mean FC of angina pectoris, exercise tolerance, vasoregulatory function of endothelium under the influence of therapy with nicorandil, isosorbide dinitrate (ISDN) and isosorbide-5-Mononitrate (I5MN) were analyzed. In patients with IHD and T2DM drug of choice for long-term treatment is nicorandil with greater antianginal and anti-ischemic efficacy compared with traditional nitrates. Nicorandil effectively corrects endothelial dysfunction, without causing the development of tolerance and without reducing its effectiveness while taking hypoglycemic therapy.
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