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Evidence of pharmacologic preconditioning during PTCA by intravenous pretreatment with ATP-sensitive K+ channel
Hitoshi Matsuo1, Sachiro Watanabe, Tomonori Segawa
1Gifu Prefectural Hospital, Gifu, Japan.
European Heart Journal
|July 23, 2003
Summary
Nicorandil pretreatment protects the heart during coronary angioplasty by inducing a cellular preconditioning effect. This protective mechanism operates independently of improved blood flow or collateral recruitment, reducing ischemic injury.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Investigating the preconditioning effect of nicorandil, an ATP-sensitive K+ channel opener.
- Determining if nicorandil's protective effect is independent of increased collateral recruitment.
Purpose of the Study:
- To evaluate the myocardial preconditioning effect of nicorandil pretreatment in patients undergoing percutaneous transluminal coronary angioplasty (PTCA).
- To assess whether nicorandil's effect is independent of changes in myocardial blood flow or collateral circulation.
Main Methods:
- A randomized trial involving 44 angina patients undergoing PTCA.
- Intravenous nicorandil or saline pretreatment before balloon inflation.
- Assessment of myocardial ischemia using 99mTc tetrofosmin SPECT and ECG-measured ST elevation (sigmaST).
Main Results:
- Nicorandil pretreatment significantly reduced ST elevation (sigmaST) compared to controls (p=0.0052).
- No significant difference in defect severity (myocardial perfusion) was observed between groups.
- Multivariate analysis confirmed nicorandil pretreatment and defect severity as significant predictors of sigmaST levels.
Conclusions:
- Nicorandil pretreatment induces myocardial preconditioning independent of ischemia severity.
- The findings suggest a cellular protective mechanism of nicorandil against ischemic injury, not solely reliant on improved blood flow.
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