Nicorandil affords cardioprotection in patients with acute myocardial infarction treated with primary percutaneous transluminal coronary angioplasty: assessment with thallium-201/iodine-123 BMIPP dual SPECT.
BACKGROUND
It has been reported that nicorandil restores blood flow to reperfused myocardium in patients with acute myocardial infarction. However, whether nicorandil might decrease infarct size remains unclear. The aim of this study was to assess the effect of nicorandil on infarct size with thallium-201/beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP) dual-isotope single photon emission computed tomography.


METHODS
A total of 62 patients were randomly assigned to receive intravenous nicorandil (4 mg in 5 minutes at admission, immediately followed by 6 mg/hr over a 24-hour period) or placebo. All patients were divided into 4 groups: Group N-a, 16 patients with preexisting angina treated with nicorandil; N-b, 15 patients without preexisting angina treated with nicorandil; C-a, 14 patients with preexisting angina given placebo; C-b, 17 patients without preexisting angina given placebo. Tl-201/BMIPP imaging was performed in the 62 patients within 7 days after admission. Dual-isotope single photon emission computed tomographic images were quantified by severity index with a polar map.


RESULTS
The BMIPP severity index was similar among the 4 groups. Only the thallium severity index in the N-a group was significantly less (P<.05). The ratio of the thallium severity index to that of BMIPP in the N-a group was significantly decreased compared with those of the other groups.


CONCLUSIONS
Nicorandil has a protective effect in patients with acute myocardial infarction and preexisting angina treated with primary balloon angioplasty.
Fukuzawa
S
S
Division of Cardiology, Funabashi Municipal Medical Center, Chiba, Japan. sf2938@mmc.funabashi.chiba.jp
Ozawa
S
S
Inagaki
M
M
Shimada
K
K
Sugioka
J
J
Tateno
K
K
Ueda
M
M
D000789:Angina, Unstable / Q000150:complications / Q000188:drug therapy; D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation; D005227:Fatty Acids; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D009206:Myocardium / Q000378:metabolism; D020108:Nicorandil / Q000008:administration & dosage*; D015221:Potassium Channels / Q000187:drug effects; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D013794:Thallium Radioisotopes / Q000627:therapeutic use*; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents / Q000008:administration & dosage*; D016277:Ventricular Function, Left
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D015221:Potassium Channels; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; C049338:iodofiltic acid; D020108:Nicorandil