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Updated: Jun 24, 2026
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Nicorandil to Prevent Contrast-Associated Kidney Injury in High-Risk PCI
Minqi Liao1, Weiliang Zhou1, Wenbin Wang1
1Department of Cardiology, Dongguan People's Hospital (The Tenth Affiliated Hospital of Southern Medical University), China (M.L., W.Z., W.W., Y. Yang, Y. Yao, G.Z., Zhihao Wu, X.Z., B.W., G.L., Z.L., Zhanyang Wei, J.L., Y.W., A.L., S.G.).
Circulation. Cardiovascular Interventions
|June 23, 2026
Summary
Oral nicorandil significantly reduced contrast-associated acute kidney injury in patients undergoing percutaneous coronary intervention with renal dysfunction. A dose of 10 mg three times daily proved effective, offering a new prophylactic strategy.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Patients with renal dysfunction face high risks of contrast-associated acute kidney injury (CA-AKI) despite standard care.
- Standard peri-procedural hydration may be insufficient for preventing CA-AKI in this vulnerable population.
Purpose of the Study:
- To investigate the efficacy of peri-procedural oral nicorandil in preventing CA-AKI.
- To evaluate the dose-response relationship of nicorandil for renoprotection.
Main Methods:
- A prospective, multicenter, randomized controlled trial was conducted.
- Patients with renal dysfunction undergoing percutaneous coronary intervention were randomized into high-dose nicorandil (30 mg/d), conventional-dose nicorandil (15 mg/d), or saline control groups.
- The primary endpoint was the incidence of CA-AKI.
Main Results:
- A total of 585 patients were enrolled.
- CA-AKI incidence was significantly lower in both nicorandil groups compared to the control group (10.9% and 8.7% vs. 19.8%, P<0.001).
- Relative risk reduction for CA-AKI was 50% for conventional-dose and 61% for high-dose nicorandil.
Conclusions:
- Adjunctive oral nicorandil, especially at 10 mg three times daily, significantly reduces CA-AKI in patients with renal dysfunction undergoing PCI.
- Oral nicorandil offers a readily available, effective, and dose-dependent prophylactic strategy for renoprotection.
- Further research is needed to assess long-term clinical benefits.
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