Key result
Pre-procedure nicorandil plus clopidogrel is linked to ~52% lower MACE risk in PCI for ACS.
Why the study?
Platelet aggregation is key to thrombosis after PCI, prompting evaluation of the effects of nicorandil combined with clopidogrel on platelet activation and cardiac function injury in ACS patients.
Does pre-procedure intravenous nicorandil combined with clopidogrel improve platelet activation and cardiac function in patients with acute coronary syndrome undergoing PCI?
Observational (n=174)
No
Does pre-procedure intravenous nicorandil combined with clopidogrel improve platelet activation and cardiac function in patients with acute coronary syndrome undergoing PCI?
Answers are grounded in this paper and cite their sources.
Pre-procedure intravenous nicorandil added to dual antiplatelet therapy may reduce platelet activation, improve cardiac function, and lower 6-month MACE risk in ACS patients undergoing PCI.
Background Platelet aggregation is key to thrombosis after PCI surgery. The effects of nicorandil combined with clopidogrel on platelet activation and cardiac function injury in patients with ACS after PCI were examined. Methods 174 patients with ACS receiving PCI were equally divided into control group (taking clopidogrel before PCI) and active group (nicorandil and clopidogrel in combination before PCI). Measurement of CD62p, CD63p and PAR was done for reflecting platelet activation, BV, PV and PSV for hemodynamics, and LVEDD, LVESD, LVEF, BNP, MMP-9 and CK-MB for cardiac function. Results CD62p, CD63p, PAR, PV and BV levels decreased while PSV increased eminently at 24 h post-operation, whose changes in research group were greater than the control group. Postoperation, BNP and MMP-9 decreased while CK-MB increased in both groups, which were significantly lower in research group. The reduction of LVEDD and LVESD and the increase of LVEF were tested after operation, which were more prominent in research group. Patients in the nicorandil group had a better prognosis. Conclusion Pre-procedure combined application of nicorandil and clopidogrel in patients with ACS undergoing PCI can effectively reduce the platelet activation, contributing to the recovery of patients’ cardiac function after intervention.
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Cai et al. (2025) conducted an observational in Acute Coronary Syndrome (ACS) undergoing PCI (n=174). Nicorandil and Clopidogrel vs. Clopidogrel 75 mg/day (300 mg loading dose) was evaluated on Total adverse cardiovascular events (p=0.012). Pre-procedure administration of nicorandil combined with clopidogrel significantly reduced the incidence of major adverse cardiovascular events to 14.94% compared to 31.03% with clopidogrel alone in patients with ACS undergoing PCI.
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