Rationale and design of a large-scale trial using nicorandil as an adjunct to percutaneous coronary intervention for ST-segment elevation acute myocardial infarction: Japan-Working groups of acute myocardial infarction for the reduction of Necrotic Damage by a K-ATP channel opener (J-WIND-KATP).
BACKGROUND
The benefits of percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) are limited by reperfusion injury. In animal models, nicorandil, a hybrid of an ATP-sensitive K(+) (KATP) channel opener and nitrates, reduces infarct size, so the Japan-Working groups of acute myocardial Infarction for the reduction of Necrotic Damage by a K-ATP channel opener (J-WIND-KATP) designed a prospective, randomized, multicenter study to evaluate whether nicorandil reduces myocardial infarct size and improves regional wall motion when used as an adjunctive therapy for AMI.


RESULTS
Twenty-six hospitals in Japan are participating in the J-WIND-KATP study. Patients with AMI who are candidates for PCI are randomly allocated to receive either intravenous nicorandil or placebo. The primary end-points are (1) estimated infarct size and (2) left ventricular function. Single nucleotide polymorphisms (SNPs) that may be associated with the function of KATP-channel and the susceptibility of AMI to the drug will be examined. Furthermore, a data mining method will be used to design the optimal combined therapy for post-myocardial infarction (MI) patients.


CONCLUSIONS
It is intended that J-WIND-KATP will provide important data on the effects of nicorandil as an adjunct to PCI for AMI and that the SNPs information that will open the field of tailor-made therapy. The optimal therapeutic drug combination will also be determined for post-MI patients.
Minamino
Tetsuo
T
Japan Foundation for Aging and Health for Medical Frontier Strategy Research by Health and Labor Sciences Research Grants.
Jiyoong
Kim
K
Asakura
Masanori
M
Shintani
Yasunori
Y
Asanuma
Hiroshi
H
Kitakaze
Masafumi
M
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures; D002985:Clinical Protocols; D003402:Creatine Kinase / Q000097:blood; D003625:Data Collection; D004562:Electrocardiography; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D009336:Necrosis; D020108:Nicorandil / Q000008:administration & dosage*; D015221:Potassium Channels / Q000819:agonists; D015427:Reperfusion Injury / Q000517:prevention & control; D012107:Research Design; D018401:Sample Size; D020107:Troponin T / Q000097:blood; D016277:Ventricular Function, Left / Q000187:drug effects
D015415:Biomarkers; D015221:Potassium Channels; D020107:Troponin T; D020108:Nicorandil; D003402:Creatine Kinase