Myocardial protective effects of nicorandil during percutaneous coronary intervention in patients with unstable angina.
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.
Kim
Ju Han
JH
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwnagju, Korea.
Jeong
Myung Ho
MH
Yun
Kyung Ho
KH
Kim
Kye Hun
KH
Kang
Dong Koo
DK
Hong
Seo Na
SN
Lim
Sang Yup
SY
Lee
Sang Hyun
SH
Lee
Yun Sang
YS
Hong
Young Joon
YJ
Park
Hyung Wook
HW
Kim
Weon
W
Ahn
Young Keun
YK
Cho
Jeong Gwang
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
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
D015415:Biomarkers; D002316:Cardiotonic Agents; D020108:Nicorandil; D007548:Isosorbide Dinitrate