Usefulness of myocardial contrast echocardiography with nicorandil stress for the detection of coronary artery stenosis

Intravenous myocardial contrast echocardiography (MCE) during pharmacological stress has emerged as a promising tool to detect myocardial perfusion abnormalities in patients with coronary artery disease (CAD). In the testing, dipyridamole or adenosine is commonly used as a stressor agent. Most patients, however, develop certain minor side effects during administration of these agents.1 Nicorandil, a hybrid ATP-sensitive potassium channel opener and nitrate compound, has been suggested to exert a coronary vasodilatation effect with few adverse reactions.2 This study tested the hypothesis that MCE with nicorandil may provide comparable diagnostic accuracy for the detection of coronary stenosis with fewer adverse reactions than with the conventional stress MCE with dipyridamole. This study enrolled 88 consecutive patients with suspected CAD but with no history of infarction who were scheduled for coronary angiography. The mean (SD) age of the patients was 66.3 (9.7) years. The study was approved by the hospital ethics committee and informed consent was obtained from all patients. The patients were randomly assigned to two groups undergoing MCE: with dipyridamole infusion (dipyridamole group, n  =  44) and with nicorandil infusion (nicorandil group, n  =  44). MCE was performed with ultraharmonic imaging equipped with a broadband phased-array transducer (S3) transmitting and …