ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1517266
This article is part of the Research TopicCoronary Microcirculation: Diagnosis Treatment and Basic ResearchView all articles
Effectiveness of Nicorandil on Myocardial Perfusion in Patients Undergoing Off-pump Coronary Artery Bypass Grafting
Provisionally accepted
- The Affiliated Hospital of Qingdao University, Qingdao, China
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Objective: This study was designed to examine the effects of nicorandil infusion on flow in arterial and venous grafts and microcirculation among patients undergoing off-pump coronary artery bypass grafting.Methods: A total of 178 eligible patients were selected from the hospital case database, with a total of 356 grafts (146 [41%] arteries and 210 [59%] veins) undergoing isolated coronary artery surgery, assigned to either the nicorandil group or the control group in a 1:1 ratio depending on whether nicorandil was used intraoperatively. Patients in nicorandil group (n=89) received nicorandil infusion during the surgery, and those in the control non-nicorandil group (n=89) did not receive nicorandil infusion. All the grafts were measured intra-operatively with an intraoperative transit time flowmetry. The left internal mammary artery flow and the total venous flow were mainly compared. Furthermore, 99 patients with coronary angiography results were chosen (50 from nicorandil group and 49 from non-nicorandil group) to assess whether their coronary arteries have coronary microvascular dysfunction (CMD) by using functional tests. Accordingly, both nicorandil group and non-nicorandil group were further divided into two subgroups—with and without CMD. Arterial bridge and total venous bridge flow were compared between the subgroups.Results: Significant improvement occurred in nicorandil group compared with non-nicorandil group in terms of the graft flow of the left internal mammary artery and the total venous bridge (P<0.05). No statistically significant difference was found in the pulsatility index values of the left internal mammary artery and the total venous bridge flow for both groups. The graft flows of nicorandil group with CMD were greater than those of non-nicorandil group with CMD (P<0.05). Conversely, there was no statistically significant difference between nicorandil group and non -nicorandil group without CMD.Conclusion: Nicorandil may have a significant effect on myocardial blood perfusion and microcirculation in coronary artery bypass graft operations and may reduce the onset of postoperative ventricular arrhythmias.Key words：graft flow,Nicorandil,CMD,CHD
Keywords: Formal analysis, methodology, Writing -review & editing. yujie jiang: Conceptualization, Data curation, investigation, Writing -original draft. qingjiang wang: Investigation, supervision, Writing -review & editing. haoyu hu: Investigation
Received: 25 Oct 2024; Accepted: 16 May 2025.
Copyright: © 2025 jiang, yan, yu, 王, hu, wang and yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: sumin yang, The Affiliated Hospital of Qingdao University, Qingdao, China
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