title: Intracoronary nicorandil prior to reperfusion in acute myocardial infarction.
abstract: BACKGROUND
  A prospective, randomised, single centre study was designed to test the safety and efficacy of nicorandil infusion, a potassium channel opener, prior to reperfusion in ST-elevation acute myocardial infarction (STEMI).
  
  
  RESULTS
  Seventy STEMI patients with TIMI 0 to 2 flow were randomly assigned to nicorandil (Group N; n = 35) or control (Group C; n = 35) and underwent direct percutaneous coronary intervention (PCI). In Group N, 2 mg of nicorandil was infused directly into the infarct area prior to reperfusion. Incidence of anterior infarction was 60% in both groups. With nicorandil infusion, additional ST elevations without chest pain were observed for a few minutes in 94% of cases. However, no ventricular fibrillation or ventricular tachycardia occurred. TIMI myocardial perfusion grade 3 was significantly higher in Group N (40% vs. 17%, p<0.01). Patients were followed for up to 8 months, with similar incidence of major clinical adverse events, however left ventricular regional wall motion score significantly improved in Group N (P < 0.05). The effect of nicorandil was seen in patients without ischaemic preconditioning (P < 0.05).
  
  
  CONCLUSIONS
  This study suggests that direct infusion of nicorandil prior to revascularisation may be safe and beneficial.
authors.affiliation: Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Miyazawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Jiro
authors.initials: J
authors.lastname: Aoki
authors.forename: Raisuke
authors.initials: R
authors.lastname: Iijima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakayama
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Hatori
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.forename: Shuzo
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hara