Korean Circ J.  2005 Apr;35(4):322-327. 10.4070/kcj.2005.35.4.322.

The Clinical Effects of Nicorandil during Percutaneous Coronary Intervention in Patients with Unstable Angina

• Kim JH
• Jeong MH
• Lim SY
• Lee SH
• Lee YS
• Yoon KH
• Kang DG
• Kim KH
• Hong YJ
• Park HW
• Park OY
• Kim W
• Ahn YK
• Cho JG
• Park JC
• Kang JC

• KMID: 2029736
• DOI: http://doi.org/10.4070/kcj.2005.35.4.322

Abstract

BACKGROUND AND OBJECTIVES
The purpose of the study was to evaluate the clinical effect of Nicorandil during percutaneous coronary intervention (PCI) in patients with unstable angina (UA).
SUBJECTS AND METHODS
Two hundred patients (61+/-10 years, male 143) with UA were randomly assigned to two groups: intravenous Isosorbide dinitrate (Group I, n=100) and intravenous Nicorandil (Group II, n=100). PCI was performed 12-48 hours after infusion of the agents. The post-procedural cardiac enzymes, 6-month MACE (major adverse cardiac event) and left ventricular ejection fraction (LVEF) were compared between the two groups.
RESULTS
Successful PCI was performed in 96 patients (Group I=54, Group II=42). Patients requiring either emergent coronary angiography, temporary pacemaker or platelet glycoprotein IIb/IIIa receptor blocker were excluded. No significant differences were observed between the two groups in terms of the clinical and coronary angiographic characteristics. The level of creatine kinase-MB was elevated in 9 (17%) and 6 patients (14%), troponin T in 16 (30%) and 6 (14%) and troponin I in 25 (46%) and 9 (21%) patients of Groups I and II, respectively, after the PCI. The elevation of all troponins was lower in Group II (28 vs. 10 patients, p=0.01). MACE developed in 9 (17%) and 5 (12%) patients of Groups I and II (p=NS), respectively, during the 6-month clinical follow-up. The LVEF was higher in Group II than in Group I on follow-up echocardiography (65.4+/-7.2% vs. 71.0+/-6.7%, p=0.003).
CONCLUSION
Nicorandil may have a myocardial protective effect during PCI in patients with UA.

Keyword

Angina; Nitroglycerin; Nicorandil; Angioplasty

MeSH Terms

Angina, Unstable*
Angioplasty
Blood Platelets
Coronary Angiography
Creatine
Echocardiography
Follow-Up Studies
Glycoproteins
Humans
Isosorbide Dinitrate
Male
Nicorandil*
Nitroglycerin
Percutaneous Coronary Intervention*
Stroke Volume
Troponin
Troponin I
Troponin T
Creatine
Glycoproteins
Isosorbide Dinitrate
Nicorandil
Nitroglycerin
Troponin
Troponin I
Troponin T