title: Intravenous nicorandil in conjunction with coronary reperfusion therapy is associated with better clinical and functional outcomes in patients with acute myocardial infarction.
abstract: The aim of this retrospective study was to assess whether intravenous nicorandil, a hybrid of NO and a KATP channel opener, in conjunction with percutaneous coronary intervention (PCI) improves the long-term prognosis in patients with acute myocardial infarction (AMI). Intravenous nicorandil has already been shown to improve the in-hospital prognosis of patients with anterior AMI. The study population consisted of 272 patients with a reperfused AMI who were admitted during a similar time interval, before (control; n=114) and after nicorandil treatment (n=158). In the nicorandil group, a 4 mg bolus injection was given, followed by 6 mg/h infusion for 24 h and then oral nicorandil at 15 mg/day for at least 1 month. In the patients with an anterior AMI, left ventricular (LV) function was better and the frequency of LV remodeling was lower after 3 months in the nicorandil group; however, in those with a non-anterior AMI, there were no differences in functional outcome and the frequency of LV remodeling between the 2 groups. The frequency of cardiac events was significantly lower in the nicorandil group, and the use of nicorandil was derived as a potential factor related to freedom from cardiac events (p<0.01, odds ratio = 0.27). Nicorandil treatment was associated with better myocardial perfusion and a better functional and clinical outcome than PCI alone, and this beneficial effect was maintained for a long time, particularly in patients with anterior AMI.
authors.affiliation: Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Iwakura
authors.forename: Masashi
authors.initials: M
authors.lastname: Ikushima
authors.forename: Akinobu
authors.initials: A
authors.lastname: Kato
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Kimura
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogihara
authors.forename: Shigeo
authors.initials: S
authors.lastname: Kawano
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D020108:Nicorandil / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D014665:Vasodilator Agents; D020108:Nicorandil