Nicorandil reduces the incidence of minor cardiac marker elevation after coronary stenting

Masaaki Murakami, Kohichiro Iwasaki, Shozo Kusachi, Kazuyoshi Hina, Minoru Hirota, Satoshi Hirohata, Shigeshi Kamikawa, Mutsuko Sangawa, Keizo Yamamoto, Yasushi Shiratori

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21 Citations (Scopus)

Abstract

Background: Minor cardiac marker elevation after percutaneous coronary intervention has long-term prognostic significance. We examined whether nicorandil, a nicotinamide-nitrate ester, reduces the incidence of minor cardiac marker elevation after coronary stenting. Methods: Patients (n = 192) undergoing coronary stenting were randomly assigned to receive nicorandil (nicorandil group, n = 91) or vehicle (control group, n = 101). Nicorandil (2 μg/kg/min, intravenously) was administered immediately after the patients were transferred into the catheterization laboratory and continued for 6 h. We measured the serum concentrations of creatine kinase isoenzyme MB (CK-MB) before, immediately after, and 6, 12, and 24 h after the procedure, and those of cardiac troponin T (cTnT) 24 h after the procedure. Results: There was no significant difference in clinical background between the 2 groups. The nicorandil group showed a significantly lower incidence of CK-MB elevation (> 1 × upper limit of control range, 20 IU/l) than the control group (8.8% vs 21.8%, p < 0.05). The levels of serum CK-MB in the nicorandil group were significantly lower than those in the control group (13.4 ± 5.7 vs 16.5 ± 9.7 IU/l, p < 0.01). Similarly, the nicorandil group showed a significantly lower incidence of cTnT elevation [> 1 × (0.1 ng/ml) or > 2 × (0.2 ng/ml)] upper limit of control range than the control group (14.3% vs 26.7%, p < 0.05, or 7.7% vs 17.8%, p < 0.05). Serum cTnT levels were also significantly lower in the nicorandil group than in the control group (0.05 ± 0.10 vs 0.15 ± 0.36 ng/ml, p < 0.05). Conclusions: The results demonstrated that nicorandil reduces minor cardiac marker elevation after coronary stenting.

Original languageEnglish
Pages (from-to)48-53
Number of pages6
JournalInternational Journal of Cardiology
Volume107
Issue number1
DOIs
Publication statusPublished - Feb 8 2006

Keywords

  • Coronary disease
  • Coronary intervention
  • Creatine kinase
  • Drugs
  • Myocardial injury
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Murakami, M., Iwasaki, K., Kusachi, S., Hina, K., Hirota, M., Hirohata, S., Kamikawa, S., Sangawa, M., Yamamoto, K., & Shiratori, Y. (2006). Nicorandil reduces the incidence of minor cardiac marker elevation after coronary stenting. International Journal of Cardiology, 107(1), 48-53. https://doi.org/10.1016/j.ijcard.2005.02.034