Rational Pharmacotherapy in Cardiology

Advanced search


Full Text:


Aim. To assess the effect of nicorandil added to the standard therapy of patients with stable ischemic heart disease (IHD) on the quality of life (QoL).

Material and methods. Patients with verified IHD (stable angina; n=120) were included into double-blind, placebo-controlled, parallel group study. All patients in the study received metoprolol tartrate (100 mg daily). Nicorandil was added (10 mg BID, and then after 2 weeks 20 mg BID) to the treatment of patients of the main group. Placebo was added to treatment of patients in the control group. The study duration was 6 weeks. QoL was assessed by theSeattle questionnaire (SAQ) and visual analogue scale (VAS) at baseline and at the end of the study.

Results. A significant decrease in the number of angina attacks was found in the nicorandil group compared to baseline [from 3.0 (2.0, 5.0) to 1.2 (0.7, 2.0); p<0.01] and compared to the placebo group [2.0 (1.0, 3.0); p=0.02]. The positive dynamics of QoL and functionality of patients with IHD was observed in the nicorandil group at the end of the study. It was demonstrated by significant improvement in all SAQ scales compared to baseline. Positive dynamics in the control group was found only in three scales (limitation of physical activity, frequency of angina attacks and patient attitude to the disease). VAS data revealed a significant increase in the integral index in patients of the main group (from 65.0±14.5 to 69.3±15.1; p=0.07), that was significantly higher than this in control group (64.6±15.1; p=0.02) at the end of the study.

Conclusion. Nicorandil addition to the standard therapy of patients with IHD (stable angina) demonstrated improvement in the QoL, assessed by SAQ questionnaire and VAS.

About the Authors

S. Yu. Martsevich
State Research Centre for Preventive Medicine
Russian Federation

Martsevich Sergey Yurievich - MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy, State Research Centre for Preventive Medicine

Petroverigsky per. 10, Moscow, 101990

N. P. Kutishenko
State Research Centre for Preventive Medicine
Russian Federation
Kutishenko Natalia Petrovna - MD, PhD, Head of Laboratory of Pharmacoeconomic Studies, Department of Preventive Pharmacotherapy

A. D. Deev
State Research Centre for Preventive Medicine
Russian Federation
Deev Alexander Dmitrievich - PhD in Mathematics and Physics, Head of Laboratory of Biostatistics, Department of Epidemiology of Chronic Non-Communicable Diseases


1. Writing Group Members, Mozaffarian D., Benjamin E.J., Go A.S., et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133(4):e38360.

2. Task Force Members, Montalescot G., Sechtem U., Achenbach S., et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949-3003.

3. Spertus J.A., Jones P., McDonell M., et al. Health status predicts long-term outcome in outpatients with coronary disease. Circulation. 2002;106(1):43-9.

4. Boden W.E., O’Rourke R.A., Teo K.K., et al. Optimal Medical Therapy with or without PCIfor Stable Coronary Disease. N Engl J Med. 2007;356(15):1503-16.

5. Boden W.E. COURAGE 5 years on: the message grows stronger. Heart. 2012;98(24):1757-60.

6. IONA Study Group. Effect of nicorandil on coronary events in patients with stable angina: the Impact Of Nicorandil in Angina (IONA) randomised trial. Lancet. 2002;359(9314):1269-75.

7. Japanese Coronary Artery Disease (JCAD) Study Investigators. Current status of the background of patients with coronary artery disease in Japan. Circ J. 2006;70(10):1256–62.

8. Sakata Y., Nakatani D., Shimizu M., et al. Oral treatment with nicorandil at discharge is associated with reduced mortality after acute myocardial infarction. J Cardiol. 2012;59(1):14-21.

9. Fox K., Garcia M.A.A., Ardissino D., et al. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J. 2006;27(11):1341-81.

10. Archbold R.A. Comparison between National Institute for Health and Care Excellence (NICE) and European Society of Cardiology (ESC) guidelines for the diagnosis and management of stable angina: implications for clinical practice. Open Hear. 2016;3(1):e000406.

11. Martsevich S.Y., Kutishenko N.P., Deev A.D. on behalf of the study participants KVAZAR. Comparative Assessment of Antianginal Efficacy and Safety of Nicorandil at the Background of Therapy With β-Adrenoblockers in Ischemic Heart Disease Patients With Stable Angina. Kardiologiia. 2016;10:304. (In Russ.) [Марцевич С.Ю., Кутишенко Н.П., Деев А.Д., от имени участников исследования КВАЗАР. Сравнительная оценка антиангинальной эффективности и безопасности препарата никорандил на фоне базисной терапии β-адреноблокаторами у больных ишемической болезнью сердца со стабильной стенокардией. Кардиология. 2016;(10):30-4].

12. Spertus J.A., WinderJ.A.,Dewhurst T.A., et al.Development and evaluation of the Seattle Angina questionnaire: A new functional status measure for coronary artery disease. J Am Coll Cardiol. 1995;25(2):333-41.

13. Frampton J., Buckley M.M., Fitton A. Nicorandil. A review of its pharmacology and therapeutic efficacy in angina pectoris. Drugs. 1992;44(4):625-55.

14. Witchitz S., Darmon J.Y. Nicorandil safety in the long-term treatment of coronary heart disease. Cardiovasc Drugs Ther. 1995;9 Suppl 2:237-43.

15. Kinoshita M., Sakai K. Pharmacology and therapeutic effects of nicorandil. Cardiovasc Drugs Ther. 1990;4(4):1075-88.

16. Hanai Y., Mita M., Hishinuma S., Shoji M. Systematic review on the short-term efficacy and safety of nicorandil for stable angina pectoris in comparison with those of β-blockers, nitrates and calcium antagonists. Yakugaku Zasshi. 2010;130(11):1549-63.

17. Jiang J., Li Y., Zhou Y., et al. Oral nicorandil reduces ischemic attacks in patients with stable angina: A prospective, multicenter, open-label, randomized, controlled study. Int J Cardiol. 2016;224:183-7.

18. Ryabikhin E.A., Mozheiko M.E., Krasilnikova Y.A. Assessment of the Impact of Nicorandil on the Quality of Life and Prognosis Indicators in Patients With Stable Angina. Kardiologiia. 2016:11:12-7. (In Russ.) [Рябихин Е.А., Можейко М.Е., Красильникова Ю.А. Оценка влияния терапии никорандилом на показатели качества жизни и прогноза у больных стабильной стенокардией. Кардиология. 2016;(11):12-7].

19. Sizova Zh.M., Zakharova V.L., Kozlova N.V., Kuchkina T.S. Influence of the potassium Channels activator nicorandil on the Quality of life in patients with ishemic heart disease and stable angina pectoris. Kardiologiia. 2016;6:26-31. (In Russ.) [Сизова Ж.М., Захарова В.Л., Козлова Н.В., Кучкина Т.С. Влияние активатора калиевых каналов никорандила на качество жизни больных ишемической болезнью сердца со стабильной стенокардией напряжения. Кардиология. 2016;6(6):26-31].

For citation:

Martsevich S.Yu., Kutishenko N.P., Deev A.D. THE ASSESSMENT OF NICORANDIL EFFECT ON THE QUALITY OF LIFE IN PATIENTS WITH STABLE ANGINA IN THE "KVAZAR" STUDY. Rational Pharmacotherapy in Cardiology. 2016;12(6):654-660. (In Russ.)

Views: 676

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)