Salutary effect of adjunctive intracoronary nicorandil administration on restoration of myocardial blood flow and functional improvement in patients with acute myocardial infarction

• Published in: The American heart journal Vol. 133; no. 6; pp. 616 - 621
• Main Authors: Sakata, Yasuhiko, Kodama, Kazuhisa, Komamura, Kazuo, Lim, Young-Jae, Ishikura, Fuminobu, Hirayama, Atsushi, Kitakaze, Masafumi, Masuyama, Tohru, Hori, Masatsugu
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.06.1997; Elsevier
• Subjects: Angioplasty, Balloon, Coronary; Antianginal agents. Coronary vasodilator agents; Biological and medical sciences; Cardiovascular system; Contrast Media; Coronary Circulation - drug effects; Coronary Vessels; Echocardiography; Female; Humans; Injections; Ioxaglic Acid; Male; Medical sciences; Microcirculation - drug effects; Middle Aged; Myocardial Contraction; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - drug therapy; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Niacinamide - administration & dosage; Niacinamide - analogs & derivatives; Niacinamide - therapeutic use; Nicorandil; Pharmacology. Drug treatments; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - therapeutic use; Potassium Channels - agonists; Thrombolytic Therapy; Sonography; Human; Agonist; Vasodilator agent; Echocardiography; Nicorandil; Infarct; Treatment efficiency; Coronary artery; Instrumentation therapy; Cardiovascular disease; Exploration; Ionic channel; Instrumental dilatation; Coronary heart disease; Contrast; Chemotherapy; Treatment; Myocardium; Combined treatment; Intraarterial administration; Potassium; Comparative study
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(97)70162-5

Salutary effect of nicorandil, a K + adenosine triphosphate channel opener, on restoration of myocardial blood flow and functional improvement after coronary revascularization was investigated in 20 patients with first anterior acute myocardial infarction. Ten patients received intracoronary administration of nicorandil (2 mg) after coronary revascularization; the other 10 patients received coronary revascularization only and served as control subjects. Myocardial contrast echocardiography and two-dimensional echocardiography were performed to assess microvascular integrity and regional function in the infarcted area. Nicorandil improved peak contrast intensity ratio ( p < 0.001), calculated as the ratio of peak contrast intensity in the infarcted and noninfarcted areas, indicating the restoration of myocardial blood flow to the infarcted myocardium. Regional wall motion improved more significantly in 1 month in patients who received nicorandil ( p < 0.01). Thus our results suggested the usefulness of intracoronary nicorandil administration after coronary revascularization for restoring blood flow and functional improvement in patients with acute myocardial infarction. (Am Heart J 1997;133:616-21.)