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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

Effect of intra-coronary nicorandil administration prior to reperfusion in acute ST segment elevation myocardial

Han Cheol Lee1, Sung Gyu An, Jae-Hoon Choi

  • 1Division of Cardiology, Department of Internal Medicine, College of Medicine, Pusan National University, Pusan National University Hospital, Busan, Republic of Korea. glaraone@hanmail.net

Circulation Journal : Official Journal of the Japanese Circulation Society
|August 30, 2008
PubMed

Insights

Intracoronary nicorandil reduced reperfusion complications like no-reflow and ventricular arrhythmia during percutaneous coronary intervention (PCI) for acute myocardial infarction (MI), improving myocardial perfusion.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Intravenous nicorandil aids cardiac function post-percutaneous coronary intervention (PCI) in acute myocardial infarction (MI).
  • Limited data exists on intracoronary nicorandil's efficacy in acute MI patients undergoing PCI.

Purpose of the Study:

  • To evaluate the effectiveness of intracoronary nicorandil in reducing reperfusion injury during PCI for acute ST-segment elevation MI.

Main Methods:

  • A randomized study involved 73 acute ST-segment elevation MI patients undergoing PCI.
  • Patients were assigned to receive either intracoronary nicorandil (Nicorandil Group, n=37) or a control (Control Group, n=36).
  • Composite endpoints included ventricular arrhythmia, no-reflow, and slow flow, with Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow assessed.

Main Results:

  • The Nicorandil Group showed a significant reduction in the composite endpoint (p=0.037).
  • Post-PCI TIMI grade 3 flow was significantly higher in the Nicorandil Group (p=0.019).
  • Major adverse cardiac events were comparable between groups during hospitalization and at 30 days.

Conclusions:

  • Intracoronary nicorandil administration effectively reduces no-reflow, slow reflow, and reperfusion arrhythmias in acute MI patients undergoing PCI.
  • It improves myocardial perfusion and TIMI flow, leading to better clinical outcomes.
  • Intracoronary nicorandil is a promising therapeutic option for mitigating reperfusion injury in acute MI.
Abstract

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