Nicorandil reduces the incidence of minor cardiac marker elevation after coronary stenting.
BACKGROUND
Minor cardiac marker elevation after percutaneous coronary intervention has long-term prognostic significance. We examined whether nicorandil, a nicotinamide-nitrate ester, reduces the incidence of minor cardiac marker elevation after coronary stenting.


METHODS
Patients (n=192) undergoing coronary stenting were randomly assigned to receive nicorandil (nicorandil group, n=91) or vehicle (control group, n=101). Nicorandil (2 mug/kg/min, intravenously) was administered immediately after the patients were transferred into the catheterization laboratory and continued for 6 h. We measured the serum concentrations of creatine kinase isoenzyme MB (CK-MB) before, immediately after, and 6, 12, and 24 h after the procedure, and those of cardiac troponin T (cTnT) 24 h after the procedure.


RESULTS
There was no significant difference in clinical background between the 2 groups. The nicorandil group showed a significantly lower incidence of CK-MB elevation (>1x upper limit of control range, 20 IU/l) than the control group (8.8% vs 21.8%, p<0.05). The levels of serum CK-MB in the nicorandil group were significantly lower than those in the control group (13.4+/-5.7 vs 16.5+/-9.7 IU/l, p<0.01). Similarly, the nicorandil group showed a significantly lower incidence of cTnT elevation [>1x (0.1 ng/ml) or >2x (0.2 ng/ml)] upper limit of control range than the control group (14.3% vs 26.7%, p<0.05, or 7.7% vs 17.8%, p<0.05). Serum cTnT levels were also significantly lower in the nicorandil group than in the control group (0.05+/-0.10 vs 0.15+/-0.36 ng/ml, p<0.05).


CONCLUSIONS
The results demonstrated that nicorandil reduces minor cardiac marker elevation after coronary stenting.
Murakami
Masaaki
M
Department of Medicine and Medical Science, Okayama University Graduates School of Medicine and Dentistry, Okayama, Japan.
Iwasaki
Kohichiro
K
Kusachi
Shozo
S
Hina
Kazuyoshi
K
Hirota
Minoru
M
Hirohata
Satoshi
S
Kamikawa
Shigeshi
S
Sangawa
Mutsuko
M
Yamamoto
Keizo
K
Shiratori
Yasushi
Y
D000368:Aged; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000628:therapy; D052279:Creatine Kinase, MB Form / Q000097:blood* / Q000187:drug effects; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D020108:Nicorandil / Q000494:pharmacology / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D020107:Troponin T / Q000097:blood* / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
D015415:Biomarkers; D020107:Troponin T; D014665:Vasodilator Agents; D020108:Nicorandil; D052279:Creatine Kinase, MB Form