Comparison of the effects of nitroprusside versus nicorandil on the slow/no-reflow phenomenon during coronary interventions for acute myocardial infarction

Kobatake, Renpei; Sato, Tetsuya; Fujiwara, Yasukazu; Sunami, Hiroshi; Yoshioka, Ryo; Ikeda, Tetsuya; Saito, Hironori; Ujihira, Toru

doi:10.1007/s00380-010-0065-5

Cited by 37 publications

(16 citation statements)

References 22 publications

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“…That is to say, if one patient's ST2 level exceeded 2.003 ng/mL, we should pay more attention to him/her during PCI or even preventively coronary administration of drugs such as adenosine, nitroprusside or nicorandil before stenting. 29,30 However, in the present study, after collection of peripheral blood samples by venepuncture, it took more than 2 h to obtain the results of sST2 measurement using this Human ST2 ELISA Kit (Medical & Biological Laboratories). As a result, doctors might have missed the optimum PPCI time.…”

Section: Discussionmentioning

confidence: 89%

Predictive value of soluble suppression of tumourigenicity 2 on myocardial reperfusion

Bai

Liu

et al. 2020

Internal Medicine Journal

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Background High baseline level of soluble suppression of tumourigenicity 2 (sST2) was an independent predictor of cardiovascular death and heart failure in ST‐segment elevation myocardial infarction (STEMI). Aims To investigate the value of serum sST2 baseline levels in predicting myocardial reperfusion in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI). Methods Consecutive STEMI patients who underwent PPCI within 12 h after the onset of chest pain were enrolled, and were divided into Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grading (TMPG) 0/1/2 group and TMPG 3 group based on post‐procedural TMPG. Baseline clinical characteristics, lesions and procedural characteristics were compared. Univariate logistic regression and multivariate linear logistic analysis were performed to identify independent predictors of impaired myocardial reperfusion (TMPG 0/1/2). Receiver‐operating characteristics curve (ROC) analysis of sST2 was performed to identify the optimum cut‐off value for predicting the myocardial reperfusion. Results A total of 121 patients was enrolled in this study. Univariate logistic regression analysis showed that Killip II–III, high levels of sST2 and brain natriuretic peptide were risk factors of TMPG 0/1/2. Multivariable logistic regression analysis revealed that sST2 was an independent predictor of impaired myocardial reperfusion (odds ratio 12.318, 95% confidence interval 4.567–33.220, P < 0.001). ROC curve analysis showed that the area under curve of sST2 was 0.849, and the best cut‐off value was 2.003 ng/mL, with a sensitivity of 89.2% and a specificity of 67.9%. Conclusion The elevated levels of sST2 on admission were associated with impaired myocardial reperfusion in STEMI patients undergoing PPCI.

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Section: Discussionmentioning

confidence: 89%

Predictive value of soluble suppression of tumourigenicity 2 on myocardial reperfusion

Bai

Liu

et al. 2020

Internal Medicine Journal

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“…Possible explanation for the similar final coronary flow status may be the use of adjunctive intracoronary pharmacological treatment and/or additional thrombectomy. Intracoronary administration of nicorandil [9-12], verapamil [11,12] or nitroprusside [13,14] has been shown to preserve coronary flow during PcI. In addition, several studies have shown that thrombectomy is effective in patient with aMI [15,16].…”

Section: Discussionmentioning

confidence: 98%

Long-term prognostic impact of the attenuated plaque in patients with acute coronary syndrome

et al. 2014

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Several intravascular ultrasound studies have reported that culprit lesion-attenuated plaque (AP) is related to slow flow/no reflow after percutaneous coronary intervention (PCI). Long-term prognostic impact of the AP is unknown. The aim of this study was to investigate acute and long-term clinical impact of the AP in patients with acute coronary syndrome (ACS). A total of 110 ACS patients who underwent successful PCI were enrolled. Acute and long-term clinical outcomes were compared between patients with AP (AP group: n = 73) and those without AP (non-AP group: n = 37). Long-term cardiac event was defined as a composite of death and ACS. Baseline characteristics in 2 groups were similar. AP was associated with higher TIMI frame count immediately after the first balloon inflation. After thrombectomy and intracoronary drug administration, final TIMI frame count became similar between AP and non-AP group. Although AP was associated with higher incidence of fatal arrhythmia during hospitalization, in-hospital mortality did not differ between the 2 groups. During follow-up (median 6.2 years), cardiac event-free survival did not differ between the 2 groups. Despite the initial unfavorable effect on coronary reflow, presence of AP did not affect acute as well as long-term clinical outcome in patients with ACS.

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“…24,25 From the literature, there is greater experience with the usage of SNP as compared to other drugs. A study done by (Kobatake R et al) 26 showed that compared to Nicorandil; SNP was more effective in improving the slow/no-reflow associated with PCI in MI patients and also in the improvement of longterm clinical outcomes. In a cross-over study done on STEMI patients, intracoronary Nicorandil more effectively reduced the index of microvascular resistance dysfunction compared to nitroglycerin after PCI (Ito N et al).…”

Section: Discussionmentioning

confidence: 99%

Does Periprocedural Nicorandil Improve Cardiovascular Outcomes in Acute Myocardial Infarction? - Meta-Analysis

Goenka¹,

George²,

Karthikeyan³

2016

jebmh

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BACKGROUND Nicorandil in conjunction with Percutaneous Coronary Intervention (PCI) has shown to improve the coronary reflow. It is not known if use of Nicorandil could lead to improvement in short and long-term cardiovascular outcomes. MATERIALS AND METHODS Literature evaluation was done to determine the efficacy of Nicorandil in improving the cardiovascular outcomes in Acute Myocardial Infarction (AMI) patients in the setting of PCI. The search terms used were Nicorandil and AMI and PCI using MEDLINE and Science Direct. Study Design-A systematic review and meta-analysis. RESULTS Thirteen randomised clinical trials were identified. Nicorandil significantly reduced in-hospital outcomes (RD: 0.16; 95%, CI:-0.23 to-0.09; I 2 : 95%; p<0.00001; FE model). There was a reduction in the number of patients with thrombolysis in myocardial infarction (TIMI flow ≤2) grade (RD: 0.06; 95%, CI:-0.09 to-0.02; I 2 : 95%; p=0.002; FE model). There was no significant difference in the major adverse cardiovascular events between Nicorandil and controls when assessed between 30 days to 8 months after discharge. CONCLUSION While Nicorandil clearly appears to have a benefit in improving in-hospital cardiovascular outcomes, it remains to be seen if this could translate into improved long-term cardiovascular outcomes.

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Comparison of the effects of nitroprusside versus nicorandil on the slow/no-reflow phenomenon during coronary interventions for acute myocardial infarction

Cited by 37 publications

References 22 publications

Predictive value of soluble suppression of tumourigenicity 2 on myocardial reperfusion

Predictive value of soluble suppression of tumourigenicity 2 on myocardial reperfusion

Long-term prognostic impact of the attenuated plaque in patients with acute coronary syndrome

Does Periprocedural Nicorandil Improve Cardiovascular Outcomes in Acute Myocardial Infarction? - Meta-Analysis

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