Intravenous administration of nicorandil immediately before percutaneous coronary intervention can prevent slow coronary flow phenomenon.
OBJECTIVE
To determine the effect of intravenous administration of nicorandil on slow coronary flow (SCF) phenomenon in patients undergoing percutaneous coronary intervention (PCI).


RESULTS
In a preliminary study, 6 mg of nicorandil showed optimal efficacy for vasodilatation without causing significant haemodynamic instability. In the main study, a total of 408 patients were randomly assigned to receive intravenous administration of 6 mg of nicorandil immediately before PCI. The number of patients in the nicorandil group was 206 [acute coronary syndrome (ACS): 47, non-ACS: 159] and that in the control group was 202 (ACS: 61, non-ACS: 141). Nicorandil significantly decreased the incidence of post-procedural SCF phenomenon in both the ACS and non-ACS groups. The rate of target vessel revascularization (TVR) was significantly lower in the nicorandil group than in the control group in ACS patients.


CONCLUSIONS
Our simple procedure prevented SCF phenomenon not only in patients with ACS but also in patients with non-ACS without any adverse effect. Additionally our procedure reduced the rate of TVR in patients with ACS.
Kawai
Yusuke
Y
Department of Cardiology, National Hospital Organization Okayama Medical Center, Tamasu, Okayama, Japan.
Hisamatsu
Kenichi
K
Matsubara
Hiromi
H
Dan
Kazuhiro
K
Akagi
Satoshi
S
Miyaji
Katsumasa
K
Munemasa
Mitsuru
M
Fujimoto
Yoshihisa
Y
Kusano
Kengo F
KF
Ohe
Tohru
T
D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000628:therapy*; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects* / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D020108:Nicorandil / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D020108:Nicorandil