Beneficial Effects of Intracoronary Nicorandil on Microvascular Dysfunction After Primary Percutaneous Coronary Intervention: Demonstration of Its Superiority to Nitroglycerin in a Cross-Over Study

Ito, Noritoshi; Nanto, Shinsuke; Doi, Yasuji; Kurozumi, Yuma; Natsukawa, Tomoaki; Shibata, Hiroyuki; Morita, Masaya; Kawata, Akihiro; Tsuruoka, Ayumu; Sawano, Hirotaka; Okada, Ken; Sakata, Yasuhiko; Tsuiki, Kai; Hayashi, Takuma

doi:10.1007/s10557-013-6456-y

Cited by 38 publications

(21 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is the only potassium channel opener which has the effect of antiangina pectoris, playing an effective role in the expansion of artery, vein and coronary artery232425. In addition, there was no serious effect on heart rate, myocardial contractility and conduction system.…”

mentioning

confidence: 99%

The clinical effect of nicorandil on perioperative myocardial protection in patients undergoing elective PCI: A Systematic Review and Meta-Analysis

2017

Sci Rep

View full text Add to dashboard Cite

Many scholars have studied the effect of nicorandil on perioperative myocardial protection in patients undergoing elective percutaneous coronary intervention (PCI), but results are inconsistent. Therefore, we performed this meta-analysis. Finally, 16 articles, including 1616 patients, were included into this meta-analysis. Meta-analysis results showed that: (1) Nicorandil can reduce the level of CK-MB after PCI, including at 6 hours, 12 hours, 18 hours and 24 hours. (2) Nicorandil can reduce the level of TnT after PCI, including at 6 hours, 12 hours, 18 hours and 24 hours. (3) Nicorandil can reduce the incidence of adverse reactions after PCI. (4) Nicorandil cannot reduce the level of MVP after PCI, including at 12 hours and 24 hours. (5) Subgroup analysis showed that nicorandil can reduce CK-MB and TnT level at 24 hours after PCI for Chinese’s population (P < 0.05), but can not reduce CK-MB and TnT level at 24 hours after PCI for non Chinese’s population (P > 0.05). Our meta-analysis indicate that nicorandil can reduce myocardial injury and reduce the incidence of adverse reaction caused by PCI for Chinese’s population, but is not obvious for non Chinese’s population. However, this conclusion still needs to be confirmed in the future.

show abstract

mentioning

confidence: 99%

The clinical effect of nicorandil on perioperative myocardial protection in patients undergoing elective PCI: A Systematic Review and Meta-Analysis

2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Nicorandil is a dual action anti-anginal drug. It is the unique potassium channel agent with an anti-anginal properties, has an active role in the dilatation of the coronary arteries and other blood vessels [14] [15]. Moreover, no bad consequences on the contractile function, conductive system or heart rhythm has been reported [16].…”

Section: Discussionmentioning

confidence: 99%

Cardio-Protective Effects of Oral Nicorandil in Patients Undergoing Cardiac Valve Surgery

Ezzat¹,

Mohamed²,

Ghaffar³

et al. 2019

WJCD

View full text Add to dashboard Cite

Background: Reduction of myocardial reperfusion injury during cardiopulmonary bypass is an essential requirement for increasing the success rate, decreasing morbidity and mortality of open-heart surgery. Aim: To study the role of pre-operative oral nicorandil in decreasing reperfusion cardiac injury in patients subjected to cardiac valve surgery. Patients and Methods: The study included 62 patients, who were equally randomized into two groups: nicorandil group and control group. Pre-operative, intra-operative and postoperative data were reported and analyzed. Left Ventricle Ejection Fraction (LVEF) was estimated pre-operatively and postoperatively for both groups. Troponin I, creatine kinase-muscle/brain (CK-MB), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured before surgery by 24 hours then 4, 12 and 48 hours after aortic cross clamp removal. Results: Nicorandil considerably decreased TNF-α and IL-6 after 4 and 12 hours following the removal of aortic clamping. It also reduced troponin-I and CKMB at the same time points. However, there were no important changes in IL-6, TNF-α, troponin-I and CK-MB levels in control group in comparison to nicorandil group in the next 48 hours following the removal of aortic clamping. Conclusions: Pre-operative oral nicorandil expressively decreased myocardial reperfusion damage during open heart valve operations, this evidenced by the decrease in the postoperative use of inotropic drugs, considerable reduction of postoperative elevation of cardiac enzymes and inflammatory cytokines with no reported complications.

show abstract

“…As a hybrid of nitrate and ATP-sensitive potassium channel opener (28-30), nicorandil could increase the coronary blood flow (31-33), dilate the micro-coronary artery (34), lower the afterload, and protect the cardiac muscle by mimicing the ischemic preconditioning (15, 20, 35-39). To date, the mechanism of nicorandil in reducing the incidence of myocardial injury after PCI is still not well elucidated (40, 41). …”

Section: Discussionmentioning

confidence: 99%

Cardioprotective effects of single oral dose of nicorandil before selective percutaneous coronary intervention

Yang¹,

Zhang²,

Cui³

et al. 2015

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective:Nicorandil, an opener of ATP-sensitive K+ channels, was used to treat angina in patients with coronary artery disease. In this study, we aim to investigate the cardioprotective effects of single oral dose of nicorandil in patients undergoing selective percutaneous coronary intervention (PCI).Methods:One hundred and thirty-eight patients with acute coronary syndrome undergoing PCI from July 2011 to October 2012 were randomly divided into control group (group 1, n=47), 10 mg oral nicorandil group (group 2, n=45), and 20 mg oral nicorandil group (group 3, n=46) about 2 hours before procedure, respectively. Cardiac troponin I (cTnI) levels were determined at 20 ~ 24 hours after PCI.Results:There was a significant difference in the rate of any cTnI elevation among the three groups (group 1: 36.17%, group 2: 20.00%, group 3: 15.22%, p=0.0176). With respect to the frequency of cTnI elevation ≥3 and 5×the upper limit of normal (ULN), there also had statistical difference among the three groups (17.02% in group 1, 8.89% in group 2, and 4.35% in group 3, respectively for cTnI elevation ≥3× ULN, p=0.0428; 12.77% in group 1, 6.67% in group 2, and 2.17% in group 3, respectively, for cTnI elevation ≥5× ULN, p=0.0487). Logistic regression analysis showed that LVEF (OR=0.915, 95% CI=0.853-0.981) and the use of nicorandil (OR=0.516, 95% CI=0.267-0.996) before PCI were independent protective factors of myocardial injury.Conclusion:Single oral dose of nicorandil (10 mg, 20 mg) 2 hours before the PCI procedure could decrease the incidence of peri-procedure myocardial injury and PCI-related myocardial infarction.

show abstract

Beneficial Effects of Intracoronary Nicorandil on Microvascular Dysfunction After Primary Percutaneous Coronary Intervention: Demonstration of Its Superiority to Nitroglycerin in a Cross-Over Study

Abstract: Intracoronary nicorandil reduced microvascular dysfunction after primary PCI more effectively than did nitroglycerin in patients with STEMI, probably via its KATP channel-opening effect.

Cited by 38 publications

References 35 publications

The clinical effect of nicorandil on perioperative myocardial protection in patients undergoing elective PCI: A Systematic Review and Meta-Analysis

The clinical effect of nicorandil on perioperative myocardial protection in patients undergoing elective PCI: A Systematic Review and Meta-Analysis

Cardio-Protective Effects of Oral Nicorandil in Patients Undergoing Cardiac Valve Surgery

Cardioprotective effects of single oral dose of nicorandil before selective percutaneous coronary intervention

Contact Info

Product

Resources

About