Usefulness of massive oral nicorandil in a patient with variant angina refractory to conventional treatment

Intern Med. 2003 Feb;42(2):163-7. doi: 10.2169/internalmedicine.42.163.


A 67-year-old man, who was previously diagnosed with vasospastic angina and treated with standard therapy, was admitted to our hospital because of recurrent chest pain refractory to sublingual nitroglycerin. Admission electrocardiography revealed ST segment elevation in II, III and aV(F), and his symptoms were relieved by intravenous bolus administration of nicorandil. He was diagnosed to have active variant angina, and remained symptomatic even after treatment with calcium antagonists and nitrates at optimal doses. Intravenous bolus administration of nicorandil was consistently effective to relieve his symptoms. Anginal attack was finally prevented by massive oral nicorandil in addition to conventional treatment.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Angina Pectoris, Variant / diagnosis*
  • Angina Pectoris, Variant / drug therapy*
  • Calcium Channel Blockers / therapeutic use
  • Coronary Angiography
  • Dose-Response Relationship, Drug
  • Electrocardiography*
  • Follow-Up Studies
  • Humans
  • Infusions, Intravenous
  • Male
  • Nicorandil / administration & dosage*
  • Nitroglycerin / therapeutic use
  • Recurrence
  • Severity of Illness Index
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage*


  • Calcium Channel Blockers
  • Vasodilator Agents
  • Nicorandil
  • Nitroglycerin