Comparison between nicorandil and magnesium as an adjunct cardioprotective agent to percutaneous coronary intervention in acute anterior myocardial infarction.
BACKGROUND
It has been reported that both nicorandil and magnesium have a cardioprotective effect in experimental ischemia - reperfusion models. In the present study, the cardioprotective effects of nicorandil and magnesium as an adjunct to reperfusion therapy in patients with acute myocardial infarction (AMI) were compared.


RESULTS
Forty consecutive patients with AMI caused by occlusion of anterior descending coronary artery were randomized into 3 groups: (1) Group N: nicorandil was given as 4 mg iv and 4 mg ic before reperfusion, followed by continuous infusion at 4 mg/h for 24 h; (2) Group M: magnesium was administered at 10 mmol iv before reperfusion, followed by continuous infusion at 0.4 mmol/h for 24 h; and (3) Group C: neither nicorandil nor magnesium was given. Left ventriculography was performed immediately after reperfusion and 3 months later. There was no significant change in regional wall motion (RWM) in either Group C or M, whereas that of group N improved significantly. The change in RWM in Group N was significantly greater than in Group C (Group N: 0.92+/-0.92, Group M: 0.44+/-0.80, Group C: -0.01+/-0.65, p<0.05).


CONCLUSIONS
The early administration of nicorandil as an adjunct to reperfusion is useful for cardioprotection in AMI, but magnesium is not.
Nameki
Mizuo
M
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Japan. nameki0circ@umin.ac.jp
Ishibashi
Iwao
I
Miyazaki
Yoshiya
Y
Sakai
Yoshiaki
Y
Namikawa
Susumu
S
Kuriyama
Nehiro
N
Komiyama
Nobuyuki
N
Tsunoda
Kouichi
K
Masuda
Yoshiaki
Y
Komuro
Issei
I
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008274:Magnesium / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D015425:Myocardial Reperfusion; D020108:Nicorandil / Q000008:administration & dosage* / Q000627:therapeutic use; D012307:Risk Factors
D002316:Cardiotonic Agents; D020108:Nicorandil; D008274:Magnesium