Nicorandil suppressed myocardial injury after percutaneous coronary intervention.
BACKGROUND
Nicorandil exerts beneficial effects as an adjunctive therapy for patients with ischemic heart disease. This study was designed to assess the effects of nicorandil on the myocardial protective benefits of elective percutaneous coronary intervention (PCI).


METHODS
We randomly divided 49 patients scheduled to undergo elective PCI into two groups, nicorandil and control. Before PCI, the former received an intravenous bolus injection of nicorandil (4 mg), followed by continuous infusion at 6 mg/h for 24 h after intervention. Oral administration of nicorandil was continued until follow-up coronary angiography (CAG). Serial venous blood samples, for measurement of creatine kinase (CK), creatine kinase MB isoform (CK-MB), troponin I (TnI) and myoglobin, were obtained before PCI, and at 0 h, 4 h, 24 h and 48 h after PCI. Left ventricular function and left ventricular wall motion were evaluated by means of contrast ventriculography before PCI and follow-up CAG.


RESULTS
At 24 h after PCI, elevations of cardiac enzymes were significantly suppressed in the nicorandil as compared to the control group; CK (78.1+/-34.9 versus 117.4+/-137.9 U/l, P=0.0141), CK-MB (1.57+/-1.90 versus 2.67+/-4.50 U/l, P=0.0485) and TnI (0.37+/-0.55 versus 0.86+/-1.65 ng/ml, P=0.0101). Regional left ventricular wall motion was significantly improved at follow-up in the nicorandil as compared to the control group.


CONCLUSIONS
Nicorandil suppressed elevations of cardiac enzymes after elective PCI and left ventricular wall motion was also significantly improved at follow-up, suggesting that nicorandil enhances the myocardial protective effect of PCI against angioplasty-related myocardial injury.
Isono
Tsuyoshi
T
Department of Medicine II, Cardiovascular Center, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan. tmisono617@yahoo.co.jp
Kamihata
Hiroshi
H
Sutani
Yasuo
Y
Motohiro
Masayuki
M
Yamamoto
Satoshi
S
Kyoui
Shiori
S
Iharada
Yoshiji
Y
Kurimoto
Kouji
K
Hara
Katsuko
K
Takahashi
Hakuo
H
Iwasaka
Toshiji
T
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000209:etiology* / Q000517:prevention & control*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000627:therapeutic use*; D011446:Prospective Studies
D002316:Cardiotonic Agents; D020108:Nicorandil