Nicorel: more than a second-line antianginal drug. Cardio-, neuro- and nephroprotection in clinical practice

Coronary heart disease remains one of the leading causes of morbidity and mortality, which necessitates the search for therapeutic approaches aimed not only at controlling symptoms, but also at organ protection and improving prognosis. The article summarizes current data on the pharmacological properties, clinical efficacy and safety of nicorandil (Nicorel) as a 2^nd-line antianginal drug with a multimodal mechanism of action that combines the properties of a nitric oxide donor and an activator of ATP-sensitive potassium channels. Its effect on coronary microcirculation, mechanisms of ischemic preconditioning and cellular protection of the myocardium, as well as the results of key clinical studies indicating a potential reduction in cardiovascular events and improvement of reperfusion, are analyzed. Special attention is paid to the neuro- and nephroprotective properties of the drug and its place in modern clinical recommendations and practical algorithms for the treatment of patients with ischemic heart disease is determined.

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