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Effects of Intracoronary Nicorandil on Myocardial Microcirculation and Clinical Outcomes in Patients with Acute

Liye Shi1, Ling Chen1, Guoxian Qi1

  • 1Department of Geriatric Cardiology, First Affiliated Hospital, China Medical University, No. 155 Nanjingbei Street, 110001 Heping District, Shenyang, China.

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|August 20, 2019
PubMed

Insights

Intracoronary nicorandil improved myocardial microcirculation in acute myocardial infarction (AMI) patients undergoing primary percutaneous coronary intervention (PPCI). However, this intervention did not lead to significant improvements in clinical outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Myocardial reperfusion remains a challenge in acute myocardial infarction (AMI) patients undergoing primary percutaneous coronary intervention (PPCI).
  • Optimizing microcirculatory function is crucial for improving outcomes in these patients.

Purpose of the Study:

  • To evaluate the efficacy of intracoronary nicorandil in improving myocardial microcirculation and clinical outcomes.
  • This meta-analysis synthesized data from randomized controlled trials (RCTs) to assess nicorandil's impact.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, Embase, Cochrane Library, Web of Science) up to April 2019.
  • Seven RCTs with 562 patients were included in this meta-analysis.
  • Pooled risk ratios (RRs) were calculated to determine treatment effects.

Main Results:

  • Intracoronary nicorandil significantly improved myocardial microcirculation, indicated by reduced rates of Thrombolysis In Myocardial Infarction (TIMI) grade ≤2 and improved TIMI myocardial perfusion grade.
  • Higher complete ST-segment resolution rates were observed in the nicorandil group.
  • No significant benefits were found for major clinical outcomes, including death, recurrent myocardial infarction, heart failure, or revascularization.

Conclusions:

  • Intracoronary nicorandil demonstrates a positive effect on myocardial microcirculation in AMI patients undergoing PPCI.
  • Despite microcirculatory improvements, nicorandil did not translate to significant clinical benefits in this patient population.
Abstract

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