Document Detail


Evidence of pharmacologic preconditioning during PTCA by intravenous pretreatment with ATP-sensitive K+ channel opener nicorandil.
MedLine Citation:
PMID:  12871686     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is not known whether pretreatment with nicorandil, an ATP-sensitive K+ channel (K(ATP)channel) opener, induces a preconditioning effect independent of increased collateral recruitment. METHODS: Forty-four patients with angina who underwent percutaneous transluminal coronary angioplasty (PTCA) to proximal left anterior descending artery (LAD) stenosis were randomly allocated for pretreatment with an intravenous injection of 80 g/kg nicorandil 5 min before initial ballooning (n=22) or saline (n=22). 99mTc tetrofosmin was injected during balloon inflation, quantitative analysis of occlusion images by SPECT was conducted, and the defect severity score (SS) was calculated. An ECG was recorded during the 2-min inflation to calculate the sum of ST elevation (sigmaST). RESULTS: SigmaST levels were significantly reduced in patients with nicorandil pretreatment compared with control patients (control:1.89+/-0.85 mV nicorandil:1.24+/-0.57 mV, p=0.0052). However, no difference was observed in defect severity (control: 79.0+/-32.5, nicorandil: 98.7+/-48.9 ns). A close correlation was observed between SS and sigmaST in both groups (nicorandil group R(2)=0.505, control group R(2)=0.599). A multivariate regression model demonstrated that both defect severity (p<0.0001) and pretreatment with nicorandil (p<0.001) were significantly related to the level of sigmaST, suggesting a cellular protective effect against ischaemia by nicorandil, independent of myocardial blood flow. CONCLUSION: Nicorandil pretreatment resulted in the induction of myocardial preconditioning independent of the severity of ischaemia.
Authors:
Hitoshi Matsuo; Sachiro Watanabe; Tomonori Segawa; Shinji Yasuda; Takeshi Hirose; Makoto Iwama; Shinichiro Tanaka; Takahiko Yamaki; Yukihiko Matsuno; Masaaki Tomita; Shinya Minatoguchi; Hisayoshi Fujiwara
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European heart journal     Volume:  24     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-21     Completed Date:  2003-10-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1296-303     Citation Subset:  IM    
Affiliation:
Gifu Prefectural Hospital, Gifu, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary* / methods
Calcium Channel Agonists / therapeutic use*
Collateral Circulation
Coronary Stenosis / therapy
Female
Humans
Ischemic Preconditioning, Myocardial / methods*
Male
Middle Aged
Myocardial Ischemia / drug therapy*,  radionuclide imaging
Myocardial Revascularization
Nicorandil / therapeutic use*
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Radiopharmaceuticals / diagnostic use
Vasodilator Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Calcium Channel Agonists; 0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/Vasodilator Agents; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 65141-46-0/Nicorandil
Comments/Corrections
Comment In:
Eur Heart J. 2003 Jul;24(14):1282-4   [PMID:  12871683 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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