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Nicorandil treatment in patients with acute myocardial infarction: a meta-analysis

Katsuomi Iwakura1, Hiroshi Ito, Atsushi Okamura

  • 1Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan. iwakura@mac.com

Circulation Journal : Official Journal of the Japanese Circulation Society
|March 28, 2009
PubMed

Insights

Nicorandil improves heart function after acute myocardial infarction (AMI) when used with reperfusion therapy. This meta-analysis shows better left ventricular ejection fraction and reduced end-diastolic volume, indicating improved cardiac recovery.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Controversy exists regarding nicorandil's cardioprotective effects in acute myocardial infarction (AMI) patients undergoing reperfusion therapy.
  • A comprehensive meta-analysis was conducted to evaluate nicorandil's impact on functional outcomes post-AMI.

Purpose of the Study:

  • To assess the efficacy of nicorandil as an adjunctive therapy in patients with acute myocardial infarction (AMI).
  • To determine the effects of nicorandil on myocardial microvascular function and overall cardiac recovery after reperfusion.

Main Methods:

  • A systematic literature search was performed on MEDLINE and Google Scholar up to October 2007.
  • Seventeen studies involving 1,337 patients were included in the meta-analysis.
  • Data on Thrombolysis In Myocardial Infarction (TIMI) flow grade, left ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume index (LVEDVI) were extracted and analyzed.

Main Results:

  • Nicorandil treatment significantly reduced the incidence of poor TIMI flow grade (< or =2) post-reperfusion.
  • A significant improvement in left ventricular ejection fraction (LVEF) by 3.7% was observed in patients treated with nicorandil.
  • Nicorandil was associated with a significant reduction in left ventricular end-diastolic volume index (LVEDVI).

Conclusions:

  • Nicorandil, when used adjunctively with reperfusion therapy, demonstrates beneficial effects on microvascular function in AMI patients.
  • The findings suggest that nicorandil promotes improved functional recovery of the heart after acute myocardial infarction.
Abstract

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