Key result
Intravenous administration of 6 mg of nicorandil immediately before PCI significantly decreased the incidence of post-procedural slow coronary flow phenomenon in both ACS and non-ACS patients.
Why the study?
Does intravenous administration of 6 mg nicorandil immediately before PCI prevent slow coronary flow phenomenon in patients undergoing PCI?
RCT (n=408)
Randomized
Does intravenous administration of 6 mg nicorandil immediately before PCI prevent slow coronary flow phenomenon in patients undergoing PCI?
Intravenous administration of 6 mg nicorandil immediately before PCI safely reduces the incidence of slow coronary flow and decreases target vessel revascularization rates in ACS patients.
Supports pre-PCI nicorandil to prevent slow flow; extends RCT evidence to both ACS and non-ACS patients.
AIMS: To determine the effect of intravenous administration of nicorandil on slow coronary flow (SCF) phenomenon in patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: In a preliminary study, 6 mg of nicorandil showed optimal efficacy for vasodilatation without causing significant haemodynamic instability. In the main study, a total of 408 patients were randomly assigned to receive intravenous administration of 6 mg of nicorandil immediately before PCI. The number of patients in the nicorandil group was 206 [acute coronary syndrome (ACS): 47, non-ACS: 159] and that in the control group was 202 (ACS: 61, non-ACS: 141). Nicorandil significantly decreased the incidence of post-procedural SCF phenomenon in both the ACS and non-ACS groups. The rate of target vessel revascularization (TVR) was significantly lower in the nicorandil group than in the control group in ACS patients. CONCLUSION: Our simple procedure prevented SCF phenomenon not only in patients with ACS but also in patients with non-ACS without any adverse effect. Additionally our procedure reduced the rate of TVR in patients with ACS.
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Kawai et al. (2008) conducted an RCT in Patients undergoing percutaneous coronary intervention (PCI) (n=408). Nicorandil vs. Control was evaluated on Incidence of post-procedural slow coronary flow (SCF) phenomenon. Intravenous administration of 6 mg of nicorandil immediately before PCI significantly decreased the incidence of post-procedural slow coronary flow phenomenon in both ACS and non-ACS patients.
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