title: The effects of nicorandil on microvascular function in patients with ST segment elevation myocardial infarction undergoing primary PCI.
abstract: BACKGROUND
  Nicorandil, as a selective potassium channel opener, has dual action including coronary and peripheral vasodilatation and cardioprotective effect through ischemic preconditioning. Considering those characteristics, nicorandil was suggested to reduce the degree of microvascular dysfunction.
  
  
  METHODS
  Thirty-two patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (pPCI) were included in the study. Index of microvascular resistance (IMR) was measured in all patients immediatelly after pPCI before the after administration of Nicorandil. ST segment resolution was monitored before intervention and 60 min after terminating the procedure. Echocardiographic evaluation of myocardial function and transthoracic Doppler derived Coronary flow reserve (CFR) of infarct related artery (IRA) was performed during hospitalization and 3 months later.
  
  
  RESULTS
  IMR was significantly lower after administration of Nicorandil (9.9 ± 3.7 vs. 14.1 ± 5.1, p < 0.001). There was significant difference in ST segment elevation before and after primary PCI with administration of Nicorandil (6.9 ± 3.7 mm vs. 1.6 ± 1.6 mm, p < 0.001). Transthoracic Doppler CFR measurement improved after 3 months (2.69 ± 0.38 vs. 2.92 ± 0.54, p = 0.021), as well as WMSI (1.14 ± 0.17 vs. 1.07 ± 0.09, p = 0.004).
  
  
  CONCLUSIONS
  Intracoronary Nicorandil administration after primary PCI significantly decreases IMR, resulting in improved CFR and ventricular function in patients with STEMI undergoing primary PCI.
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. jesikakostic@yahoo.com.
authors.forename: Jelena
authors.initials: J
authors.lastname: Kostic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. skali.ana7@gmail.com.|Medical School, University of Belgrade, Belgrade, Serbia. skali.ana7@gmail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Djordjevic-Dikic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. iatros007@gmail.com.|Medical School, University of Belgrade, Belgrade, Serbia. iatros007@gmail.com.
authors.forename: Milan
authors.initials: M
authors.lastname: Dobric
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. dejan_milasinovic@yahoo.com.
authors.forename: Dejan
authors.initials: D
authors.lastname: Milasinovic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. milanned@hotmail.com.|Medical School, University of Belgrade, Belgrade, Serbia. milanned@hotmail.com.
authors.forename: Milan
authors.initials: M
authors.lastname: Nedeljkovic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. sstojkovi@open.telekom.rs.|Medical School, University of Belgrade, Belgrade, Serbia. sstojkovi@open.telekom.rs.
authors.forename: Sinisa
authors.initials: S
authors.lastname: Stojkovic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. jelena.stepanovic@kcs.ac.rs.|Medical School, University of Belgrade, Belgrade, Serbia. jelena.stepanovic@kcs.ac.rs.
authors.forename: Jelena
authors.initials: J
authors.lastname: Stepanovic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. misa.tesic@gmail.com.
authors.forename: Milorad
authors.initials: M
authors.lastname: Tesic
authors.affiliation: Military Medical Academy, Belgrade, Serbia. drtrifun@yahoo.com.|Medical Faculty, University of Defense, Belgrade, Serbia. drtrifun@yahoo.com.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Trifunovic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. danijelatrif@gmail.com.|Medical School, University of Belgrade, Belgrade, Serbia. danijelatrif@gmail.com.
authors.forename: Danijela
authors.initials: D
authors.lastname: Zamaklar-Tifunovic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. radovanovicn@sbb.rs.|Medical School, University of Belgrade, Belgrade, Serbia. radovanovicn@sbb.rs.
authors.forename: Mina
authors.initials: M
authors.lastname: Radosavljevic-Radovanovic
authors.affiliation: Medical School, University of Belgrade, Belgrade, Serbia. mostojic2011@gmail.com.
authors.forename: Miodrag
authors.initials: M
authors.lastname: Ostojic
authors.affiliation: Clinic for Cardiology, Clinical Center of Serbia, Visegradska 26, Belgrade, Serbia. branko.beleslin@gmail.com.|Medical School, University of Belgrade, Belgrade, Serbia. branko.beleslin@gmail.com.
authors.forename: Branko
authors.initials: B
authors.lastname: Beleslin
mesh_terms: D002316:Cardiotonic Agents / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D020108:Nicorandil / Q000627:therapeutic use*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D002316:Cardiotonic Agents; D020108:Nicorandil