Abstract 3161: Intravenous Nicorandil Before Reperfusion Prevents Left Ventricular Remodeling in Patients With Acute Myocardial Infarction
Background: Identifying a simple clinical method for reducing clinical risks in cases of acute myocardial infarction (AMI) is a key goal. Recently, it has been reported that nicorandil has beneficial effects on ischemic heart disease. We did a randomized study for first ST elevation AMI patients undergoing percutaneous coronary intervention (PCI) to assess the cardioprotective effects of intravenous nicorandil before reperfusion.
Methods: Patients were divided into two groups: those who received single intravenous 12 mg doses of nicorandil before reperfusion with PCI and those who received placebo. We compared left ventriculography data between the two groups.
Results: Of the patients enrolled in the study, left ventriculography at both the acute and follow-up phases was performed in 213 patients (112 patients in the nicorandil group and 101 in the placebo group). There were no differences in baseline characteristics between the two groups. In the nicorandil group, global left ventricular function at follow-up period was better than in the placebo group (ejection fraction; 59 ± 9.8% vs. 55 ± 12% p = 0.014, end-diastolic volume index; 96.1 ± 23.0 ml/m2 vs. 109 ± 32.5 ml/m2, p = 0.0011). LV-EF from acute phase to follow-up phase also significantly increased in the nicorandil group (4.3 ± 8.3% vs. 1.9 ± 7.3%, p = 0.024). Change in LV-EDV index from acute phase to follow-up phase was decreased by 2.1 ± 21.0 ml/m2 in the nicorandil group, compared to a 7.6 ± 24.0 ml/m2 increase in the placebo group (p = 0.002). As to change in LV-ESD index, a similar tendency was observed (−4.2 ± 12.1 ml/m2 vs. 1.4 ± 15.9 ml/m2, p = 0.004).
Conclusion: A single intravenous administration of 12 mg doses of nicorandil before reperfusion can prevent left ventricular remodeling and improve chronic left ventricular function following myocardial infarction.