23303
document
Impact of a single intravenous administration of nicorandil before reperfusion in patients with ST-segment-elevation myocardial infarction . BACKGROUND Intravenous nicorandil , a hybrid compound of ATP-sensitive potassium channel opener and nitric oxide donor , has been reported to ameliorate early functional and clinical problems in patients with acute myocardial infarction . However , its effects on the late phase remain unclear . METHODS AND RESULTS This follow-up study to 5 years of a randomized , double-blinded trial was conducted among 368 patients with first ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention ( PCI ) . They were randomly assigned to receive 12 mg of nicorandil or a placebo intravenously just before reperfusion . We analyzed incidence of cardiovascular death or rehospitalization for congestive heart failure after PCI as well as various aspects of epicardial flow and microvascular function . Mean follow-up was 2.4 years ( SD , 1.4 ) . A total of 12 ( 6.5 % ) patients receiving nicorandil and 30 ( 16.4 % ) receiving placebo had cardiovascular death or hospital admission for congestive heart failure ( hazard ratio , 0.39 ; 95 % CI , 0.20 to 0.76 ; P=0.0058 ) . Postprocedural TIMI 3 flow was obtained in 89.7 % of the nicorandil group and in 81.4 % of the placebo ( hazard ratio , 1.99 ; 95 % CI , 1.09 to 3.65 ; P=0.025 ) . Corrected TIMI frame count was furthermore lower in the nicorandil group ( 21.0+/-9.1 versus 25.1+/-14.1 ; P=0.0009 ) . ST-segment resolution > 50 % was observed in 79.5 % and 61.2 % of the nicorandil and placebo groups , respectively ( hazard ratio , 2.45 ; 95 % CI , 1.54 to 3.90 ; P=0.0002 ) . CONCLUSIONS The addition of intravenous nicorandil to PCI leads to beneficial clinical outcomes and prevents cardiovascular events of long duration and death in patients with ST-segment-elevation myocardial infarction .
23304
Intervention_Pharmacological
nicorandil
23305
Intervention_Pharmacological
nicorandil
23306
Intervention_Pharmacological
nicorandil
23307
Intervention_Control
placebo
23308
Intervention_Pharmacological
nicorandil
23309
Intervention_Control
placebo
23310
Intervention_Pharmacological
nicorandil
23311
Intervention_Control
placebo
23312
Intervention_Pharmacological
nicorandil
23313
Intervention_Pharmacological
nicorandil
23314
Intervention_Control
placebo
23315
Intervention_Pharmacological
nicorandil
23316
Outcome_Mortality
cardiovascular death
23317
Outcome_Other
rehospitalization
23318
Outcome_Physical
congestive heart failure
23319
Outcome_Mortality
cardiovascular death
23320
Outcome_Physical
hospital admission
23321
Outcome_Physical
congestive heart failure
23322
Outcome_Physical
Postprocedural TIMI 3 flow
23323
Outcome_Physical
Corrected TIMI frame count
23324
Outcome_Physical
ST-segment resolution > 50 %
23325
Outcome_Physical
clinical outcomes
23326
Outcome_Physical
cardiovascular events of long duration
23327
Outcome_Mortality
death
23328
Participant_Condition
ST-segment-elevation myocardial infarction
23329
Participant_Condition
acute myocardial infarction
23330
Participant_Sample-size
368
23331
Participant_Condition
first ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention