Effects of Early Intracoronary Administration of Nicorandil During Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

The impact of oral nicorandil pre-treatment on ST resolution and clinical outcome of patients with acute ST-segment elevation myocardial infarction undergoing primary coronary angioplasty: A randomized placebo controlled trial

“…This finding is in contrary to those found in the most of previous studies where the drug was used through either intravenous or intracoronary route. [6][7][8][9]13,14 Also, in the present study, oral nicorandil did not have any effect on infarct size reduction and left ventricular function as evident by similar peak cardiac troponin and left ventricular ejection fraction (Table 1) . These findings are consistent with those reported by Kitakaze et al, who showed the intravenous nicorandil with no effect on either infarct size or left ventricular function.…”

“…5 Previous studies have shown that intravenous or intracoronary nicorandil may have cardioprotective effects and may lead to increased myocardial salvage in patients with STEMI undergoing mechanical reperfusion. [6][7][8][9][10] However, in a majority of previous studies, nicorandil has been administered either intravenously or intracoronary, and there is paucity of data on possible cardioprotective effect of oral nicorandil before primary coronary angioplasty. 11,12 Therefore, in the present study, we aimed to assess cardioprotective effect of oral nicorandil during primary angioplasty in patients with STEMI.…”

Cardiovascular events associated with nicorandil administration prior to primary percutaneous coronary intervention in patients with acute ST-segment elevated myocardial infarction: a systematic review and meta-analysis

“…The mean age was 63.0 ± 10.0 years and 76.6% of the patients were male. All 10 studies were published in English [23][24][25][26][27][28][29][30][31] or Chinese [32]. Five studies had been conducted in Japan, four in China, and one in South Korea.…”

“…We also recorded the time from onset of symptoms/STEMI to reperfusion. Four of the studies [24][25][26]30] were considered high quality (Table 2). Table 3 lists the outcomes reported in the studies.…”

“…Pooled analyses with a fixedeffects model suggested a significant reduction in in-hospital MACE in patients who received nicorandil (24.6% vs. 46.9%; OR 0.16, 95% CI 0.09-0.27; P = 0.00, P heterogeneity = 0.17, I 2 = 34.5%, Figure 1). Seven studies [23,25,[28][29][30][31][32] with 876 patients reported follow-up MACE with the outcomes of death (2.3% vs. 4.8%), non-fatal myocardial infarction (1.4% vs. 2.5%), post-infarction angina (0.9% vs. 1.6%), repeat revascularization (7.3% vs. 8.0%), and re-hospitalization for congestive heart failure (3.4% vs. 8.0%). Our analysis suggested a significant reduction in follow-up MACE in patients who received nicorandil (15.3% vs. 24.9%; OR 0.53, 95% CI 0.37-0.75; P = 0.00, P heterogeneity = 0.87, I 2 = 0.0%, Figure 2).…”