Nicorandil attenuates ventricular dysfunction and organ injury after cardiopulmonary bypass

Peng, Yun-Wen; Major, Terry C.; Deatrick, Kristopher B.; Mohammed, Azmath; Jeakle, Mark; Charpie, John R.

doi:10.1016/j.ijcard.2022.08.030

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…Additionally, an animal study have shown that the administration of NICD during rabbit CPB surgery exerts a protective influence on the heart, brain, and kidney. 31 Take together, these findings collectively support the perspective that NICD possesses a multi-organ protective effect, which holds significant clinical relevance in the context of cardiac surgery involving CPB related multiple organ injury.…”

Section: Discussionsupporting

confidence: 65%

Effect of Perioperative Nicorandil on Myocardial Protection in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass, a Retrospective Study

Chen,

Liu,

et al. 2024

DDDT

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Background The potential myocardial protective effect of nicorandil (NICD) in patients undergoing percutaneous coronary intervention has been established. However, its efficacy in the context of cardiac surgery remains controversial. The present study aimed to evaluate the myocardial protective effect of perioperative NICD use in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods We retrospectively gathered data from patients undergoing cardiac bypass surgery between 12/2018 and 04/2021 in Fuwai Hospital. Subsequently, the patients were divided into two groups, NICD group and non-nicorandil (non-NICD) group. A 1, 3 propensity score matching (PSM) was conducted. The primary outcome was the incidence of myocardial injury. The secondary outcomes included the mechanical ventilation (MV) duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, duration of chest drainage, the drainage volume, the total cost, the incidence of acute kidney injury (AKI), and the incidence of acute liver injury (ALI). Subsequently, we divided the entire population into two distinct subgroups based on their administration of NICD, and performed a comprehensive subgroup analysis. Results A total of 2406 patients were ultimately included in the study. After PSM, 250 patients in NICD group and 750 patients in non-NICD group were included in the analysis. Perioperative NICD reduced the incidence of myocardial injury (47.2% versus 38.8%, P=0.025). Our subgroup analysis revealed that preoperative NICD administration not only provided myocardial protection benefits (45.7% vs 35.8%, OR 0.66, 95% CI [0.45–0.97], P=0.041), but also demonstrated statistically significant reduction in ALI, the ICU and hospital LOS, and the duration of chest drainage (all P<0.05). Conclusion The perioperative NICD administration may confer myocardial protection in patients undergoing cardiac surgery with CPB. Furthermore, the preoperative utilization of NICD has the potential to mitigate the incidence of postoperative ALI, a reduction in the ICU and hospital LOS, and the duration of chest drainage.

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Section: Discussionsupporting

confidence: 65%

Effect of Perioperative Nicorandil on Myocardial Protection in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass, a Retrospective Study

Chen,

Liu,

et al. 2024

DDDT

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“…Still, there is no clear indication for the non-Chinese population. (19)The results stated here draw attention to the fact that nicorandil, one of the drugs used to control symptoms, can be given to patients in addition to PCI to reduce the number of patients who experienced myocardial infarction and preserve myocardial function.…”

Section: Discussionmentioning

confidence: 95%

Efficacy and Safety of Nicorandil for Periprocedural Myocardial Injury in Patients Undergoing Pci

SHAH,

KHAN,

KHAN

2024

Biol Clin Sci Res J

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Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, with percutaneous coronary intervention (PCI) being a typical therapeutic approach. Objectives: In this comparative study, we aimed to investigate the efficacy and safety of nicorandil for periprocedural myocardial injury in patients undergoing PCI. Methods: This comparative study was conducted at Ayub Teaching Hospital from September 2023 to December 2023. Data from 90 patients was recruited for the research using inclusion and exclusion screening standards. Our study was performed on 90 patients treated with percutaneous coronary intervention (PCI). Patients from Group 1 were different from those in Group 2. Group A: the critical study parameters will switch between those patients who received nicorandil and Group B: non-nicorandil patients. Baseline demographic data, past medical history, and relevant laboratory values and clinical characteristics were documented for all patients. In addition, an intraoperative laboratory investigation was conducted, including cardiac biomarkers. Results: Research data were drawn from 90 patients whose gender wasn't a factor based on the research protocol. In Group A, the mean age of the patients was 62 years. Players in group A played for 4 ± 8.5 years. In team B, the players had a slightly longer experience and played for 63. Humans on Earth could do the same, and it could significantly impact future generations: ± 7. 9 years. Of 58 men and 32 women in the control group, there were two persons and persons in the experimental group, respectively. Only one stent differed between the two groups; however, the number was similar. 8 ± 0. 6 mmol/l in the tricorandil group and 1. +9 ± 0 in Case 1. Patients in the Nicorandil group displayed the lowest level of heart problem-causing protein (troponin) at the peak (5. There is a statistically significant 1.8-fold (2 ng/mL versus seven ng/mL) decline in serum lysozyme levels in the group administered rhG-CSF. The treatment group exhibited a substantial increase in haemoglobin levels (t(12) = 3. 74, p-value <0.005) with a mean difference of 0. 5 ± 2 ng/mL. 001, 95% CI: 2. 1 to 3. 5). Conclusion: It is concluded that nicorandil shows positive results for the efficacy (the ability of a drug to bring the desired effect) and safety of the drug in reducing myocardial injury and in maintaining the function of myocardial during percutaneous coronary intervention in patients.

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“…Nicorandil is widely used in the treatment of coronary heart disease and has a dual effect as a nitric oxide (NO) donor and increases cell membrane permeability to potassium ions. It has been shown to alleviate oxidative stress, inflammation, and apoptosis induced by ischemia-reperfusion ( 149 , 150 ). A recent randomized double-blind controlled trial showed that nicorandil administered before primary PCI could improve the myocardial perfusion grade and increase the ejection fraction, and reduce myocardial infarct size in patients with ST-segment elevation MI ( 151 ).…”

Section: Discussionmentioning

confidence: 99%

A bibliometric analysis of myocardial ischemia/reperfusion injury from 2000 to 2023

Wang

Guo

Zhang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundMyocardial ischemia/reperfusion injury (MIRI) refers to the more severe damage that occurs in the previously ischemic myocardium after a short-term interruption of myocardial blood supply followed by restoration of blood flow within a certain period of time. MIRI has become a major challenge affecting the therapeutic efficacy of cardiovascular surgery.MethodsA scientific literature search on MIRI-related papers published from 2000 to 2023 in the Web of Science Core Collection database was conducted. VOSviewer was used for bibliometric analysis to understand the scientific development and research hotspots in this field.ResultsA total of 5,595 papers from 81 countries/regions, 3,840 research institutions, and 26,202 authors were included. China published the most papers, but the United States had the most significant influence. Harvard University was the leading research institution, and influential authors included Lefer David J., Hausenloy Derek J., Yellon Derek M., and others. All keywords can be divided into four different directions: risk factors, poor prognosis, mechanisms and cardioprotection.ConclusionResearch on MIRI is flourishing. It is necessary to conduct an in-depth investigation of the interaction between different mechanisms and multi-target therapy will be the focus and hotspot of MIRI research in the future.

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Nicorandil attenuates ventricular dysfunction and organ injury after cardiopulmonary bypass

Cited by 6 publications

References 26 publications

Effect of Perioperative Nicorandil on Myocardial Protection in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass, a Retrospective Study

Effect of Perioperative Nicorandil on Myocardial Protection in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass, a Retrospective Study

Efficacy and Safety of Nicorandil for Periprocedural Myocardial Injury in Patients Undergoing Pci

A bibliometric analysis of myocardial ischemia/reperfusion injury from 2000 to 2023

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