Abstract

Introduction: Peripheral vascular disease (PVD) is a chronic condition which affects >20% of people over 70 years. Patients with PVD are symptomatic in 40% cases. Nicorandil, a potassium channel opener that allows the vascular smooth muscle to relax, effectively dilates the microvasculature and has shown improvement in myocardial perfusion. It also prevents endothelial dysfunction and cause significant reduction in peripheral vascular resistance. This effect has the potential in improvement of symptoms in peripheral artery disease. In this study, we studied the effect of Nicorandil on claudication distance and quality of life by measuring change in Peripheral Arterial Questionnaire (PAQ) Score and Claudication distance from baseline after 4 weeks of Nicorandil therapy along with standard of care therapy. Aim: To find the effect of nicorandil on subjective claudication distance and peripheral arterial questionnaire (PAQ) in patients of peripheral arterial disease. Methods: In this pilot study done on 18 individuals with peripheral artery disease, tablet Nicorandil 10 mg twice a day was given along with Tab. Clopidogrel 75mg once a day and Tab. Atorvastatin 40mg once a day for 4 weeks and change in subjective claudication distance and quality of life was compared with the baseline data of the same parameters. Results: Out of 18, 15 (83.3%) were male, 3 (16.6%) were diabetic, 4 (22.3%) were hypertensive and 17 (94.40%) were smokers. Mean age of individuals in study was 57.6 years and mean body mass index was w19.47. There was asignificant increase in the mean subjective claudication distance after 4 weeks of nicorandil from 189.72 meters to 389.44 meters. Symptom scale improved from a mean value of 21.11 to 75.55, treatment satisfaction scale improved from 70.37 to 81.94, quality of life from 25.46 to 69.07, social function improved from 18.40 to 46.64 and mean summary score of quality of life indicators (PAQ) increased from 35.03 to 64.51. Conclusion: Our study findings have shown a significant improvement in both claudication distance as well as quality of life of patients with peripheral artery disease with nicorandil therapy. Further study on measurable parameters along with a comparator arm should be done in a larger population for establishing the role of nicorandil in PVD.

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