Effects of Combined Therapy with Isosorbide Dinitrate and Nicorandil both on the Coagulation System and on Platelet Activity after Coronary Stenting Junichi Funada 1 , Takamasa Kobayashi 1 , Michihito Sekiya 1 , Hiroshi Akutsu 1 , Akiyoshi Ogimoto 1 , Kouki Watanabe 2 1Department of Cardiology, Ehime National Hospital 2Department of Cardiology, Ehime Prefectural Minamiuwa Hospital Keyword: 冠動脈ステント , ニコランジル , 血小板機能 , coronary stenting , nicorandil , platelet activity pp.407-411
Published Date 1999/4/15
DOI https://doi.org/10.11477/mf.1404901885
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 To evaluate the effects of combined therapy using isosorbide dinitrate (ISDN) and nicorandil both on the coagulation system and on platelet activity after coronary stenting. Fibrinopeptide A, tPA-PAI 1 complex and serotonin from 21 patients were estimated after coronary stenting and on the next morning. After successful placement of coronary stents, 11 patients were randomly assigned to receive intravenous ISDN (group C) and 10 were assigned to receive combined therapy with ISDN and nicorandil (group N). The plasma level of fibrinopeptide A had increased significantly by the next morning in both groups (group C ; 1.72±0.93 to 4.42±4.30 ng/ml, p <(1.05, group N ; 1.13±0.42 to 3.57±2.64, p <0.02). The tPA-PAI I complex had increased significantly in group N ( 16.7±8.2 to36.9±26.7ng/ml, p<0.05), and in group C (18.8±9.3 to 23.9 ± 14.7, p =0.11) . Serotonin had decreased significantly in group N (3.31 ± 4.48 to 1.41±2.23 ng/ ml, p<0.05), while there was no significant change in group C (2.17 ± 2.87 to 1.69 ± 1.79 ng/ml) . Conclusion : This study demonstrates that the administration of both ISDN and nicorandil decreased plasma level of serotonin after coronary stenting. This suggests the suppression of platelet activity. Combined therapy with ISDN and nicorandil may reduce the risk of coronary thrombus formation after stenting.

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