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).

METHODS AND 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).

CONCLUSION:

This study suggests that direct infusion of nicorandil prior to revascularisation may be safe and beneficial.

• Authors: Akiyoshi Miyazawa, Yuji Ikari, Kengo Tanabe, Hiroyoshi Nakajima, Jiro Aoki, Raisuke Iijima, Tomohiro Nakayama, Mitsuharu Hatori, Gaku Nakazawa, Shuzo Tanimoto, Yoshinobu Onuma, Kazuhiro Hara
• Journal: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (EuroIntervention) Vol. 2 Issue 2 Pg. 211-7 (Aug 2006) ISSN: 1774-024X [Print] France
• PMID: 19755263 (Publication Type: Journal Article)