Protective Effect of Nicorandil Against Contrast-Induced Nephropathy in Patients with Acute Myocardial Infarction

Abstract

Purpose: Contrast-induced nephropathy (CIN) has resulted in significant hospital morbidity and mortality as use of contrast media (CM) for percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has been increasing. Nicorandil, a K-ATP channel opener and a nitric oxide donor, is used to treat angina pectoris. Therefore, we investigated whether the use of nicorandil would reduce the incidence of CIN in patients with AMI undergoing PCI. Methods: From November 2005 to August 2011, we evaluated 1,492 AMI patients with Killip class I and serum creatinine (sCr) less than 3.0 mg/dL who underwent PCI. The patients were divided into two groups: group I receiving nicorandil (n = 442) and group II not receiving nicorandil (n = 1,050). Results: Among the 1,492 patients, CIN developed in 398 (26.7%). There were no significant differences in baseline clinical characteristics between the two groups. The incidence of CIN also did not differ between two groups (25.1% vs. 27.3%, P = 0.405). The incidence of CIN and the increase in average percentage of sCr (ΔsCr) were not significantly different between the two groups (18.2% vs. 20.4%, P= 0.296). In univariate analysis, nicorandil was not an independent predictor of CIN (OR: 1.122 95%, CI: 0.87-1.446, P= 0.376). Conclusion: The use of nicorandil did not decrease the incidence of CIN in patients with AMI undergoing PCI.

Renoprotective effect of nicorandil in patients undergoing percutaneous coronary intervention: a meta-analysis of 4 randomized controlled trials

“…Park et al also assessed the renoprotective effect of nicorandil in a retrospective design [ 21 ]. A total of 1492 patients with Scr less than 3.0 mg/dL were included, and no change in the CIN incidence between nicorandil group and control group was found.…”