Comparison of the effects of nicorandil versus verapamil on the incidence of slow flow/no reflow during rotational atherectomy.
In rotational atherectomy, the slow-flow/no-reflow phenomenon is a common complication, which usually results in myocardial injury. We prospectively randomized 111 patients with successful rotational atherectomy into a verapamil group (group V, n = 56) and a nicorandil group (group N, n = 55). We compared final burr size, total ablation time, maximum decrease in revolutions per minute, incidence of slow flow/no reflow, creatine kinase-MB increase, and cardiac troponin T increase between the 2 groups. Patient and procedural characteristics were not significantly different between groups. The incidence of no reflow/slow flow was significantly lower in group N than in group V (3.6% vs 17.9%, respectively, p <0.05). The incidence of a minor increase in cardiac markers was also significantly lower in group N than in group V (creatine kinase-MB 3.6% vs 16.1%, p <0.05; cardiac troponin T 5.5% vs 21.4%, p <0.05). In conclusion, our results showed that nicorandil decreases the incidence of slow flow/no reflow during rotational atherectomy.
Iwasaki
Kohichiro
K
Department of Cardiology, Okayama Central Hospital, Okayama, Japan. iwasaki_k@kohjin.ne.jp
Samukawa
Masanobu
M
Furukawa
Hiroshi
H
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D017225:Atherectomy, Coronary / Q000009:adverse effects / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000008:administration & dosage*; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014700:Verapamil / Q000008:administration & dosage*
D000925:Anticoagulants; D015415:Biomarkers; D020107:Troponin T; D014665:Vasodilator Agents; D020108:Nicorandil; D006493:Heparin; D014700:Verapamil; D003402:Creatine Kinase