title: Effect on periprocedural myocardial infarction of intra-coronary nicorandil prior to percutaneous coronary intervention in stable and unstable angina.
abstract: BACKGROUND
  Intravenous nicorandil infusion dilates the coronary artery and reduces inflammation, coronary spasm, and arrhythmia. Periprocedural myocardial infarction (PMI) is a frequent and prognostically important complication of percutaneous coronary intervention (PCI). This prospective randomized study was designed to evaluate the efficacy of intracoronary nicorandil on PMI after elective PCI.
  
  
  RESULTS
  Eighty-one patients with stable or unstable angina undergoing PCIs of the left anterior descending artery were randomly assigned to the nicorandil group (n=41) or the control group (n=40). In the nicorandil group, 4 mg of intracoronary nicorandil was infused prior to PCI. Post-PCI, peak levels of creatine kinase (CK)-MB and troponin I were measured and angiographic findings were analyzed. Side branch status was also assessed. All PCIs were successful. One cerebrovascular infarction and one acute ST segment elevation myocardial infarction with acute stent thrombosis occurred in the nicorandil group. No deaths occurred, and no other major cardiac adverse events were observed in either group over 6 months follow-up. The post-PCI peak CK-MB and troponin I levels were not significantly different between the two groups. There were no significant differences between the nicorandil and control subjects in side branch occlusion or flow reduction, or in the jail index.
  
  
  CONCLUSIONS
  Intra-coronary nicorandil infusion had no significant effect on PMI and cardiac enzymes after PCI in patients with stable or unstable angina.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Pusan National University, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Jongmin
authors.initials: J
authors.lastname: Hwang
authors.forename: Han Cheol
authors.initials: HC
authors.lastname: Lee
authors.forename: Bo-Won
authors.initials: BW
authors.lastname: Kim
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Yang
authors.forename: Jin-Sup
authors.initials: JS
authors.lastname: Park
authors.forename: Jong-Ha
authors.initials: JH
authors.lastname: Park
authors.forename: Hye-Won
authors.initials: HW
authors.lastname: Lee
authors.forename: Junhyok
authors.initials: J
authors.lastname: Oh
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Cha
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.forename: Seunghwan
authors.initials: S
authors.lastname: Song
authors.forename: Sang-Pil
authors.initials: SP
authors.lastname: Kim
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000601:surgery*; D000789:Angina, Unstable / Q000601:surgery*; D003331:Coronary Vessels; D052279:Creatine Kinase, MB Form / Q000378:metabolism; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control*; D009206:Myocardium / Q000201:enzymology; D020108:Nicorandil / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control*; D011379:Prognosis; D011446:Prospective Studies; D019210:Troponin I / Q000378:metabolism; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D019210:Troponin I; D014665:Vasodilator Agents; D020108:Nicorandil; D052279:Creatine Kinase, MB Form
keywords: Angina; Angioplasty; Coronary disease; Drugs; Myocardial infarction