Document Detail

High index of microcirculatory resistance level after successful primary percutaneous coronary intervention can be improved by intracoronary administration of nicorandil.
MedLine Citation:
PMID:  20234097     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although microvascular dysfunction following percutaneous coronary intervention (PCI) can be evaluated with the index of microcirculatory resistance (IMR), no method of treatment has been established. We hypothesized that intracoronary administration of nicorandil can improve IMR after successful primary PCI in patients with ST-segment elevation myocardial infarction (STEMI).
METHODS AND RESULTS: In 40 patients with first STEMI after successful primary PCI, IMR was measured using PressureWire(TM) Certus (St. Jude Medical, MN, USA). In 20 of the patients (Group N), IMR was measured at baseline and after intracoronary nicorandil (2 mg/10 ml). In the other 20 patients (Control), IMR was measured at baseline, after intracoronary saline (10 ml) and after intracoronary nicorandil (2 mg/10 ml). In Group N, IMR significantly decreased after intracoronary nicorandil (median IMR, 27.7-18.7 U, P<0.0001). In the Control group, IMR did not change after saline administration (median IMR, 24.3-23.8 U, P=0.8193), but was significantly decreased after intracoronary nicorandil (median IMR, 23.8-14.9 U, P<0.0001). Next, all 40 patients were divided into subgroups by tertile of baseline IMR. In those with intermediate to high IMR (baseline IMR > or =21), intracoronary nicorandil significantly decreased IMR, although it did not change IMR in those with low IMR (baseline IMR <21).
CONCLUSIONS: High IMR levels in patients with STEMI after successful primary PCI can be improved by intracoronary administration of nicorandil.
Noritoshi Ito; Shinsuke Nanto; Yasuji Doi; Hirotaka Sawano; Daisaku Masuda; Shizuya Yamashita; Ken-ichiro Okada; Shoji Kaibe; Yasuyuki Hayashi; Tatsuro Kai; Toru Hayashi
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-03-17
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-08-13     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  909-15     Citation Subset:  IM    
Critical & Cardiovascular Care Unit, Osaka Saiseikai Senri Hospital, Suita, Japan.
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MeSH Terms
Anti-Arrhythmia Agents / administration & dosage*
Catheter Ablation*
Microcirculation / drug effects*
Middle Aged
Myocardial Infarction / physiopathology*,  therapy*
Nicorandil / administration & dosage*
Prospective Studies
Vascular Resistance / drug effects*
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 65141-46-0/Nicorandil

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