Related Experiment Video

Updated: Jun 20, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration
07:59

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Published on: April 4, 2022

Intracoronary nicorandil prior to reperfusion in acute myocardial infarction

Akiyoshi Miyazawa1, Yuji Ikari, Kengo Tanabe

  • 1Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|September 17, 2009
PubMed

Insights

Direct nicorandil infusion before reperfusion improved heart function in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). This treatment appears safe and beneficial for STEMI recovery.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • ST-elevation acute myocardial infarction (STEMI) requires timely reperfusion.
  • Nicorandil, a potassium channel opener, is investigated for its role in myocardial protection.

Purpose of the Study:

  • To evaluate the safety and efficacy of direct nicorandil infusion prior to reperfusion in STEMI patients.
  • To assess the impact of nicorandil on myocardial perfusion and left ventricular function.

Main Methods:

  • Prospective, randomized, single-center study.
  • Seventy STEMI patients with TIMI 0-2 flow received direct percutaneous coronary intervention (PCI).
  • Nicorandil (2 mg) was infused into the infarct area before reperfusion in the treatment group.

Main Results:

  • Nicorandil infusion led to transient ST elevations in 94% of patients without adverse arrhythmias.
  • Significantly higher TIMI myocardial perfusion grade 3 was observed in the nicorandil group (40% vs. 17%, p<0.01).
  • Left ventricular regional wall motion score significantly improved in the nicorandil group (P < 0.05), particularly in patients without ischemic preconditioning.

Conclusions:

  • Direct nicorandil infusion prior to revascularization appears safe and beneficial in STEMI.
  • Nicorandil may improve myocardial perfusion and left ventricular function post-STEMI.
Abstract

More Related Videos

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction05:26

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

Published on: May 28, 2019

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

Related Concept Videos

Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...