Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction

Hiroshi Itoh, Yoshiaki Taniyama, Katsuomi Iwakura, Nagahiro Nishikawa, Tohru Masuyama, Tsunehiko Kuzuya, Masatsugu Hori, Yorihiko Higashino, Kenshi Fujii, Takazo Minamino

Research output: Contribution to journalArticle

314 Citations (Scopus)

Abstract

OBJECTIVES: We assessed whether the intravenous administration of nicorandil, an adenosine triphosphate (ATP)-sensitive K+ channel opener, exerts beneficial effect on microvascular function and functional and clinical outcomes in patients with acute myocardial infarction (AMI). BACKGROUND: Experimental studies documented that ATP-sensitive K+ channel opener exerts cardioprotection after prolonged ischemia. METHODS: We randomly divided 81 patients with a first anterior AMI into two groups, nicorandil (n = 40) and control groups (n = 41). All patients received successful coronary angioplasty within 12 h after the symptom onset and underwent myocardial contrast echcardiography (MCE) with the intracoronary injection of sonicated microbubbles. In the nicorandil group, we injected 4 mg of nicorandil followed by the infusion at 6 mg/h for 24 h and by oral nicorandil (15 mg/day). RESULTS: The improvement in regional left ventricular function, wall motion score and regional wall motion was significantly better in the nicorandil group then in the control group. Intractable congestive heart failure, malignant ventricular arrhythmia and pericardial effusion were more frequently found in the control group than in the nicorandil group (15% vs. 37%, 5% vs. 20% and 8% vs. 37%, p <0.05, respectively). The frequency of sizable MCE no reflow phenomenon was significantly lower in the nicorandil group than in the control group (15% vs. 33%, p <0.05). CONCLUSIONS: Intravenous nicorandil in conjunction with coronary angioplasty is associated with better functional and clinical outcomes compared to angioplasty alone in patients with an anterior AMI. Myocardial contrast echocardiography findings imply that an improvement in microvascular function with nicorandil may be attributable to this better outcome.

Original languageEnglish
Pages (from-to)654-660
Number of pages7
JournalJournal of the American College of Cardiology
Volume33
Issue number3
DOIs
Publication statusPublished - Mar 1 1999
Externally publishedYes

Fingerprint

Anterior Wall Myocardial Infarction
Nicorandil
Angioplasty
Control Groups
Myocardial Infarction
Adenosine Triphosphate
No-Reflow Phenomenon
Microbubbles
Pericardial Effusion
Left Ventricular Function
Intravenous Administration
Echocardiography
Cardiac Arrhythmias
Ischemia
Heart Failure

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. / Itoh, Hiroshi; Taniyama, Yoshiaki; Iwakura, Katsuomi; Nishikawa, Nagahiro; Masuyama, Tohru; Kuzuya, Tsunehiko; Hori, Masatsugu; Higashino, Yorihiko; Fujii, Kenshi; Minamino, Takazo.

In: Journal of the American College of Cardiology, Vol. 33, No. 3, 01.03.1999, p. 654-660.

Research output: Contribution to journalArticle

Itoh, Hiroshi ; Taniyama, Yoshiaki ; Iwakura, Katsuomi ; Nishikawa, Nagahiro ; Masuyama, Tohru ; Kuzuya, Tsunehiko ; Hori, Masatsugu ; Higashino, Yorihiko ; Fujii, Kenshi ; Minamino, Takazo. / Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. In: Journal of the American College of Cardiology. 1999 ; Vol. 33, No. 3. pp. 654-660.
@article{fbcc26cd347b41f1818944dbb3d137d2,
title = "Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction",
abstract = "OBJECTIVES: We assessed whether the intravenous administration of nicorandil, an adenosine triphosphate (ATP)-sensitive K+ channel opener, exerts beneficial effect on microvascular function and functional and clinical outcomes in patients with acute myocardial infarction (AMI). BACKGROUND: Experimental studies documented that ATP-sensitive K+ channel opener exerts cardioprotection after prolonged ischemia. METHODS: We randomly divided 81 patients with a first anterior AMI into two groups, nicorandil (n = 40) and control groups (n = 41). All patients received successful coronary angioplasty within 12 h after the symptom onset and underwent myocardial contrast echcardiography (MCE) with the intracoronary injection of sonicated microbubbles. In the nicorandil group, we injected 4 mg of nicorandil followed by the infusion at 6 mg/h for 24 h and by oral nicorandil (15 mg/day). RESULTS: The improvement in regional left ventricular function, wall motion score and regional wall motion was significantly better in the nicorandil group then in the control group. Intractable congestive heart failure, malignant ventricular arrhythmia and pericardial effusion were more frequently found in the control group than in the nicorandil group (15{\%} vs. 37{\%}, 5{\%} vs. 20{\%} and 8{\%} vs. 37{\%}, p <0.05, respectively). The frequency of sizable MCE no reflow phenomenon was significantly lower in the nicorandil group than in the control group (15{\%} vs. 33{\%}, p <0.05). CONCLUSIONS: Intravenous nicorandil in conjunction with coronary angioplasty is associated with better functional and clinical outcomes compared to angioplasty alone in patients with an anterior AMI. Myocardial contrast echocardiography findings imply that an improvement in microvascular function with nicorandil may be attributable to this better outcome.",
author = "Hiroshi Itoh and Yoshiaki Taniyama and Katsuomi Iwakura and Nagahiro Nishikawa and Tohru Masuyama and Tsunehiko Kuzuya and Masatsugu Hori and Yorihiko Higashino and Kenshi Fujii and Takazo Minamino",
year = "1999",
month = "3",
day = "1",
doi = "10.1016/S0735-1097(98)00604-4",
language = "English",
volume = "33",
pages = "654--660",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction

AU - Itoh, Hiroshi

AU - Taniyama, Yoshiaki

AU - Iwakura, Katsuomi

AU - Nishikawa, Nagahiro

AU - Masuyama, Tohru

AU - Kuzuya, Tsunehiko

AU - Hori, Masatsugu

AU - Higashino, Yorihiko

AU - Fujii, Kenshi

AU - Minamino, Takazo

PY - 1999/3/1

Y1 - 1999/3/1

N2 - OBJECTIVES: We assessed whether the intravenous administration of nicorandil, an adenosine triphosphate (ATP)-sensitive K+ channel opener, exerts beneficial effect on microvascular function and functional and clinical outcomes in patients with acute myocardial infarction (AMI). BACKGROUND: Experimental studies documented that ATP-sensitive K+ channel opener exerts cardioprotection after prolonged ischemia. METHODS: We randomly divided 81 patients with a first anterior AMI into two groups, nicorandil (n = 40) and control groups (n = 41). All patients received successful coronary angioplasty within 12 h after the symptom onset and underwent myocardial contrast echcardiography (MCE) with the intracoronary injection of sonicated microbubbles. In the nicorandil group, we injected 4 mg of nicorandil followed by the infusion at 6 mg/h for 24 h and by oral nicorandil (15 mg/day). RESULTS: The improvement in regional left ventricular function, wall motion score and regional wall motion was significantly better in the nicorandil group then in the control group. Intractable congestive heart failure, malignant ventricular arrhythmia and pericardial effusion were more frequently found in the control group than in the nicorandil group (15% vs. 37%, 5% vs. 20% and 8% vs. 37%, p <0.05, respectively). The frequency of sizable MCE no reflow phenomenon was significantly lower in the nicorandil group than in the control group (15% vs. 33%, p <0.05). CONCLUSIONS: Intravenous nicorandil in conjunction with coronary angioplasty is associated with better functional and clinical outcomes compared to angioplasty alone in patients with an anterior AMI. Myocardial contrast echocardiography findings imply that an improvement in microvascular function with nicorandil may be attributable to this better outcome.

AB - OBJECTIVES: We assessed whether the intravenous administration of nicorandil, an adenosine triphosphate (ATP)-sensitive K+ channel opener, exerts beneficial effect on microvascular function and functional and clinical outcomes in patients with acute myocardial infarction (AMI). BACKGROUND: Experimental studies documented that ATP-sensitive K+ channel opener exerts cardioprotection after prolonged ischemia. METHODS: We randomly divided 81 patients with a first anterior AMI into two groups, nicorandil (n = 40) and control groups (n = 41). All patients received successful coronary angioplasty within 12 h after the symptom onset and underwent myocardial contrast echcardiography (MCE) with the intracoronary injection of sonicated microbubbles. In the nicorandil group, we injected 4 mg of nicorandil followed by the infusion at 6 mg/h for 24 h and by oral nicorandil (15 mg/day). RESULTS: The improvement in regional left ventricular function, wall motion score and regional wall motion was significantly better in the nicorandil group then in the control group. Intractable congestive heart failure, malignant ventricular arrhythmia and pericardial effusion were more frequently found in the control group than in the nicorandil group (15% vs. 37%, 5% vs. 20% and 8% vs. 37%, p <0.05, respectively). The frequency of sizable MCE no reflow phenomenon was significantly lower in the nicorandil group than in the control group (15% vs. 33%, p <0.05). CONCLUSIONS: Intravenous nicorandil in conjunction with coronary angioplasty is associated with better functional and clinical outcomes compared to angioplasty alone in patients with an anterior AMI. Myocardial contrast echocardiography findings imply that an improvement in microvascular function with nicorandil may be attributable to this better outcome.

UR - http://www.scopus.com/inward/record.url?scp=0033101517&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033101517&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(98)00604-4

DO - 10.1016/S0735-1097(98)00604-4

M3 - Article

VL - 33

SP - 654

EP - 660

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 3

ER -