title: Myocardial protective effects of nicorandil during percutaneous coronary intervention in patients with unstable angina.
abstract: BACKGROUND
  The purpose of the study was to prospectively evaluate the protective effect of nicorandil during percutaneous coronary intervention (PCI) in patients with unstable angina (UAP).
  
  
  RESULTS
  Two hundred patients (61+/-10 year-old, male 143) diagnosed with UAP at an emergency medical center were randomly assigned to 2 groups: intravenous isosorbide dinitrate, Group I (n=100), or intravenous nicorandil, Group II (n=100). PCI was performed 12-48 h after infusion of each agent. Serum concentrations of creatine kinase-MB (CK-MB), cardiac troponin T (cTnT), and I (cTnI) were measured before and 6, 12, 24 h after PCI. Patients with non-coronary chest pain, requiring emergency coronary angiogram, temporary pacemaker or glycoprotein IIb/IIIa receptor blocker were excluded. PCI was successfully performed in 96 patients (Group I=54, 61.7+/-8.2 years, 32 males; Group II=42, 60.4+/-11.7 years, 27 males). No significant differences in clinical or coronary angiographic characteristics were observed between the 2 groups. The concentration of CK-MB was elevated in 9 patients (17%) of Group I and 6 (14%) of Group II, cTnT in 16 (30%), 6 (14%) and cTnI in 25 (46%), 9 (21%) after PCI. Elevation of any troponin was less frequent in Group II [28/54 (52%) vs 10/42 (24%) patients, p=0.01]. Major adverse coronary events during the 6-month clinical follow-up occurred in 9 (17%) of Group I and 5 patients of Group II (12%, p=NS). Follow-up echocardiography revealed lower left ventricular ejection fraction in Group I than in Group II (65.4+/-7.2% vs 71.0+/-6.7%, p=0.03).
  
  
  CONCLUSIONS
  Nicorandil has a myocardial protective effect during PCI in patients with UAP.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwnagju, Korea.
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Yun
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Dong Koo
authors.initials: DK
authors.lastname: Kang
authors.forename: Seo Na
authors.initials: SN
authors.lastname: Hong
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Yun Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Jeong Gwang
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000601:surgery; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000008:administration & dosage*; D013318:Stroke Volume; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002316:Cardiotonic Agents; D020108:Nicorandil; D007548:Isosorbide Dinitrate