Effect of remote ischemia or nicorandil on myocardial injury following percutaneous coronary intervention in patients with stable coronary artery disease: A randomized controlled trial

Protective Effect of Remote Ischemic Preconditioning on Myocardial Damage After Percutaneous Coronary Intervention in Stable Angina Patients With Complex Coronary Lesions ― Subanalysis of a Randomized Controlled Trial ―

“…We believe that the particular population of stable angina patients and the high incidence of pMD in the control group might have affected the results for intravenous nicorandil and pMD in the original study. 15 In the current substudy, we found a lower but not significant incidence of pMD in patients in the nicorandil group compared with the control group. Although the populations in this substudy included highrisk patients, each group size was smaller than in the original study.…”

“…15 The primary outcome was the incidence of pMD following PCI, which was defined as an elevated level of high-sensitivity cardiac troponin T (cTnT: >0.07 ng/mL) or creatine kinase myocardial band (CK-MB: >10 ng/mL) and a CK-MB/creatinine kinase ratio >5% at 12 or 24 h after PCI. The definition was based on the diagnostic criteria for myocardial injury associated with PCI from the 3rd universal definition of myocardial infarction.…”

“…15 In brief, the RIPC group underwent pretreatment of upper-limb compression of 200 mmHg followed by decompression (3 cycles in total, 5-min inflation and deflation of a blood pressure cuff, at least 1 h before PCI) using a newly developed, automated continuous blood pressure device (FB-270; Fukuda Denshi, Tokyo, Japan). The nicorandil group underwent a single injection of nicorandil (4 mg) at 1 h before PCI and then a continuous infusion (6 mg/h) for not less than 8 h.…”

Protective effect of nicorandil on myocardial injury following percutaneous coronary intervention in older patients with stable coronary artery disease: Secondary analysis of a randomized, controlled trial (RINC)

“…We recently reported a multicenter, randomized trial that examined whether pre-procedural RIPC or intravenous nicorandil reduces pMI in patients who undergo elective PCI for stable CAD. This study showed that RIPC or intravenous nicorandil moderately reduced biomarker release and pMI in patients with stable CAD, but these results were not significant [ 24 ]. Therefore, an exploratory analysis to identify a population in whom RIPC or intravenous nicorandil is effective was planned.…”

Effects of Nicorandil on All-Cause Mortality and Cardiac Events in CAD Patients Receiving PCI

“…8) The serious complications of PCI that lead to a poor prognosis are no-reflow and myocardial injury. [9][10][11] Nicorandil, a potent coronary vasodilator, is a hybrid of adenosine triphosphate-sensitive potassium (KATP) channel opener and nitrates are commonly prescribed for the treatment of coronary heart disease. 3,[12][13][14] A large-scale study on stable angina, the IONA study (Impact of Nicorandil in Angina) reported that nicorandil administration not only reduced death but also decreased hospitalizations for myocardial infarction and chest pain.…”