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Sustained nicorandil administration reduces the infarct size in ST-segment elevation myocardial infarction patients with primary percutaneous coronary intervention [Anatol J Cardiol]
Anatol J Cardiol. 2019; 21(3): 163-171 | DOI: 10.14744/AnatolJCardiol.2018.57383  

Sustained nicorandil administration reduces the infarct size in ST-segment elevation myocardial infarction patients with primary percutaneous coronary intervention

Shanjie Wang1, Yu Duan1, Xinyu Feng1, Liang Liu2, Zhaofeng Shi3, Bo Wang1, Chenhai Xia1, Wanrong Man1, Haichang Wang1, Zhijing Zhao1, Dongdong Sun1
1Department of Cardiology, Xijing Hospital, Fourth Military Medical University; Xi’an-China
2Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University; Xi’an-China
3Department of Traditional Chinese Medicine, Xijing Hospital, Fourth Military Medical University; Xi’an-China

Objective: Currently, there is still no effective strategy to diminish the infarct size (IS) in patients with ST-segment elevation myocardial infarction (STEMI). According to a previous animal study, nicorandil treatment is a promising pharmaceutical treatment to limit the infarct area. In this study, we aim to investigate the effects of continual nicorandil administration on the IS and the clinical outcomes in patients with STEMI who underwent primary percutaneous coronary intervention (pPCI).
Methods: One hundred seventeen patients with STEMI and undergoing pPCI were randomly divided into the sustained nicorandil group (5 mg, three times daily) or the control group (only single nicorandil before PCI). The primary endpoint was the IS, evaluated by single-photon emission computed tomography (SPECT) 3 months after pPCI.
Results: Eighty-five patients completed the IS assessment via SPECT, and 99 participants were available for follow-up after 6 months. Finally, there was a statistical difference in the IS between the nicorandil and control groups {13% [interquartile range (IQR), 8–17] versus 16% [IQR, 12–20.3], p=0.027}. Additionally, we observed that maintained nicorandil administration significantly improved the left ventricular ejection fraction at 3 months and enhanced the activity tolerance (physical limitation and angina stability) at 6 months after PCI.
Conclusion: Sustained nicorandil treatment reduced the IS and improved the clinical outcomes compared to the single nicorandil administration for patients with STEMI undergoing the pPCI procedure. Continuous cardioprotective therapy may be more beneficial for patients with STEMI.

Keywords: nicorandil, ST-segment elevation myocardial infarction, infarct size, percutaneous coronary intervention, single-photon emission computed tomography


Shanjie Wang, Yu Duan, Xinyu Feng, Liang Liu, Zhaofeng Shi, Bo Wang, Chenhai Xia, Wanrong Man, Haichang Wang, Zhijing Zhao, Dongdong Sun. Sustained nicorandil administration reduces the infarct size in ST-segment elevation myocardial infarction patients with primary percutaneous coronary intervention. Anatol J Cardiol. 2019; 21(3): 163-171

Corresponding Author: Dongdong Sun, China


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