Nicorandil versus nitroglycerin: a pilot study
© Singh et al. 2011
Published: 1 March 2011
Continuous exposure to nitrates is associated with tachyphylaxis. This study compares the effects and tolerance during intravenous treatment with nitroglycerin and nicorandil over a 48-hour period.
Twenty patients with congestive heart failure and pulmonary capillary wedge pressure (PCWP) ≥18 mmHg were randomly assigned to nitroglycerin or nicorandil intravenous infusions. Doses were titrated to obtain a reduction of PCWP of at least 30% at 6 hours and then maintained for 48 hours.
PCWP values before and after treatment
Intravenous nicorandil administration gives similar reductions in PCWP compared with nitroglycerin with significantly less haemodynamic tolerance over a 48-hour period compared with nitroglycerin. This might represent a clinical advantage of nicorandil in the short-term treatment of patients with congestive heart failure.
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