Influence of xantinole nicotinic acid on cutaneous microcirculation in patients with coronary artery disease and hyperlipoproteinemia

Xantinole nicotinic acid (NA) dose dependently lowers plasma levels of atherogenic lipoproteins and increases blood flow through vasodilation. The aim of this study was to evaluate the effect of NA on cutaneous microcirculation in patients with coronary artery disease and hyperlipidemia. In this open pilot study, five men and three women (74.2 ± 9.1 yrs; 81.4 ± 7.9 kg; 171.6 ± 7.0 cm) with angiographically proven coronary artery disease and hyperlipidemia were included. Nailfold capillary microscopy was used for measurements of erythrocyte velocities at rest and after three minutes of ischemia, before and one hour after intake of 1000 mg of NA. The blood pressure (120 ± 12/73 ± 8 mmHg vs. 113 ± 10/72 ± 5 mmHg; p = 0.19/0.83) and the heart rate (72 ± 8/min vs. 70 ± 7/min; p = 0.38) remained unchanged. The mean capillary red blood cell velocity at rest (υ RBc ; 0.27 ± 0.23 mm/s vs. 0.32 ± 0.18 mm/s; p = 0.089) and the time to maximal post ischemia erythrocyte velocity (t peak ; 21.0 ± 7.9 s vs. 24.3 ± 15.5 s; p = 0.49) did not change. The maximal post ischemic erythrocyte velocity (υ maxRBC ; 0.93 ± 0.33 mm/s vs. 1.19 ± 0.19 mm/s; p = 0.0096) raised slightly but significantly, the duration of post-ischemia hyperemia (DpH; 101 ± 16 s vs. 127 ± 15 s; p = 0.0005) increased markedly. One patient reported about flush in the whole body. The administration of 1000 mg of NA resulted in a significant improvement of the cutaneous microcirculation in patients with coronary artery disease and hyperlipidemia.