Key result
ATP-sensitive K+ channel openers, such as nicorandil, prevent irreversible ischemia and reperfusion injury and attenuate major adverse cardiovascular events in acute myocardial infarction.
Why the study?
PCI in STEMI is associated with a 5%-7% mortality rate, driving an urgent need to develop novel drugs that effectively prevent cardiac reperfusion injury.
Do KATP channel openers prevent cardiac ischemia/reperfusion injury and improve outcomes in patients with myocardial infarction?
Do KATP channel openers prevent cardiac ischemia/reperfusion injury and improve outcomes in patients with myocardial infarction?
KATP channel openers such as nicorandil represent a promising pharmacological strategy to mitigate ischemia/reperfusion injury and improve clinical outcomes in patients undergoing PCI for STEMI.
Background The use of percutaneous coronary intervention (PCI) in patients with ST‐segment elevation myocardial infarction (STEMI) is associated with a mortality rate of 5%–7%. It is clear that there is an urgent need to develop new drugs that can effectively prevent cardiac reperfusion injury. ATP‐sensitive K + (K ATP ) channel openers (KCOs) can be classified as such drugs. Results KCOs prevent irreversible ischemia and reperfusion injury of the heart. K ATP channel opening promotes inhibition of apoptosis, necroptosis, pyroptosis, and stimulation of autophagy. KCOs prevent the development of cardiac adverse remodeling and improve cardiac contractility in reperfusion. KCOs exhibit antiarrhythmic properties and prevent the appearance of the no‐reflow phenomenon in animals with coronary artery occlusion and reperfusion. Diabetes mellitus and a cholesterol‐enriched diet abolish the cardioprotective effect of KCOs. Nicorandil, a KCO, attenuates major adverse cardiovascular event and the no‐reflow phenomenon, reduces infarct size, and decreases the incidence of ventricular arrhythmias in patients with acute myocardial infarction. Conclusion The cardioprotective effect of KCOs is mediated by the opening of mitochondrial K ATP (mitoK ATP ) and sarcolemmal K ATP (sarcK ATP ) channels, triggered free radicals' production, and kinase activation.
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Маслов et al. (2023) conducted a review in Ischemia/reperfusion cardiac injury. ATP-sensitive K+ (KATP) channel openers was evaluated. ATP-sensitive K+ channel openers, such as nicorandil, prevent irreversible ischemia and reperfusion injury and attenuate major adverse cardiovascular events in acute myocardial infarction.
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