Effect of intra-coronary nicorandil administration prior to reperfusion in acute ST segment elevation myocardial infarction.
BACKGROUND
Intravenous nicorandil infusion with percutaneous coronary intervention (PCI) has been reported to reduce reperfusion injury events and improve cardiac function in patients with acute myocardial infarction (MI). However, there is limited information on the use of intracoronary nicorandil.


RESULTS
In the present study, 73 patients with acute ST segment elevation MI undergoing PCI were randomly assigned to the Nicorandil Group (n=37) or the Control Group (n=36). The composite endpoints were the incidences of ventricular arrhythmia, no-reflow and slow flow. A significant difference in the composite endpoint was observed in the Nicorandil Group when compared with the Control Group (p=0.037). The occurrence of post Thrombolysis In Myocardial Infarction (TIMI) grade 3 was significantly higher in the Nicorandil Group (p=0.019). Major adverse cardiac events during hospitalization and within 30 days of treatment were similar between the 2 groups.


CONCLUSIONS
Administration of intracoronary nicorandil reduced the occurrence of no-reflow, slow reflow, and reperfusion arrhythmia, and improved the myocardial perfusion grade, TIMI flow during PCI and improved clinical outcomes in patients with acute MI.
Lee
Han Cheol
HC
Division of Cardiology, Department of Internal Medicine, College of Medicine, Pusan National University, Pusan National University Hospital, Busan, Republic of Korea. glaraone@hanmail.net
An
Sung Gyu
SG
Choi
Jae-Hoon
JH
Lee
Tae Kun
TK
Kim
Jun
J
Kim
June Hong
JH
Chun
Kook Jin
KJ
Hong
Taek Jong
TJ
Shin
Yung Woo
YW
Lee
Sang-Kwon
SK
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000517:prevention & control; D006328:Cardiac Catheterization; D003326:Coronary Circulation / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*; D020108:Nicorandil / Q000627:therapeutic use*; D012189:Retrospective Studies; D015912:Thrombolytic Therapy
D000889:Anti-Arrhythmia Agents; D020108:Nicorandil