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Protective Effect of Nicorandil on Contrast-Induced Acute Kidney Injury After Emergency Percutaneous Coronary

Zuo-Zhong Yu1, Zheng-Xiong Xu2, Yue-Hua Ruan1

  • 1Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

Journal of Cardiovascular Pharmacology and Therapeutics
|June 1, 2023
PubMed

Insights

Nicorandil significantly reduced contrast-induced acute kidney injury (CIAKI) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). This study highlights nicorandil as a protective factor against CIAKI.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Contrast-induced acute kidney injury (CIAKI) is a significant complication following percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).
  • Identifying effective preventative strategies for CIAKI is crucial for improving patient outcomes after emergency PCI.

Purpose of the Study:

  • To evaluate the protective effect of nicorandil on the incidence of CIAKI in STEMI patients undergoing emergency PCI.
  • To assess the impact of nicorandil on renal function markers and cardiac enzyme levels post-PCI.

Main Methods:

  • A retrospective control study involving 156 STEMI patients undergoing emergency PCI.
  • Patients were divided into a nicorandil group (n=55) and a control group (n=101).
  • CIAKI incidence, serum creatinine (Scr), estimated glomerular filtration rate (eGFR), uric acid, β2-microglobulin, and creatine kinase isoenzymes (CK-MB) were primary and secondary endpoints.

Main Results:

  • The incidence of CIAKI was significantly lower in the nicorandil group (12.7%) compared to the control group (26.7%) (P=.043).
  • Nicorandil treatment was associated with lower Scr, uric acid, and β2-microglobulin levels, and higher eGFR post-PCI (P<.05).
  • The peak CK-MB levels were lower in the nicorandil group (P=.042), with no significant difference in adverse events.

Conclusions:

  • Intravenous nicorandil demonstrates a protective effect against CIAKI in STEMI patients following emergency PCI.
  • Nicorandil treatment is identified as an independent protective factor for CIAKI, while hypertension and diabetes are risk factors.

Keywords:
ST-segment elevation myocardial infarctioncontrast-induced acute kidney injurynicorandilpercutaneous coronary intervention

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