EFFICACY AND SAFETY OF NICORANDIL FOR PERIPROCEDURAL MYOCARDIAL INJURY IN PATIENTS UNDERGOING PCI

Authors

  • SB SHAH Department of Cardiology, Ayub Teaching Hospital Abbottabad, Pakistan
  • S KHAN Department of Cardiology, National Institute of Cardiovascular Disease (NICVD) Karachi, Pakistan
  • MU KHAN Department of Cardiology, Ayub Teaching Hospital Abbottabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.835

Keywords:

Coronary Artery Disease, Myocardial Injury, Nicorandil, Percutaneous Coronary Intervention, Troponin

Abstract

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, with percutaneous coronary intervention (PCI) being a typical therapeutic approach. Objectives: In this comparative study, we aimed to investigate the efficacy and safety of nicorandil for periprocedural myocardial injury in patients undergoing PCI. Methods: This comparative study was conducted at Ayub Teaching Hospital from September 2023 to December 2023. Data from 90 patients was recruited for the research using inclusion and exclusion screening standards. Our study was performed on 90 patients treated with percutaneous coronary intervention (PCI). Patients from Group 1 were different from those in Group 2. Group A: the critical study parameters will switch between those patients who received nicorandil and Group B: non-nicorandil patients. Baseline demographic data, past medical history, and relevant laboratory values and clinical characteristics were documented for all patients. In addition, an intraoperative laboratory investigation was conducted, including cardiac biomarkers. Results: Research data were drawn from 90 patients whose gender wasn't a factor based on the research protocol. In Group A, the mean age of the patients was 62 years. Players in group A played for 4 ± 8.5 years. In team B, the players had a slightly longer experience and played for 63. Humans on Earth could do the same, and it could significantly impact future generations: ± 7. 9 years. Of 58 men and 32 women in the control group, there were two persons and persons in the experimental group, respectively. Only one stent differed between the two groups; however, the number was similar. 8 ± 0. 6 mmol/l in the tricorandil group and 1. +9 ± 0 in Case 1. Patients in the Nicorandil group displayed the lowest level of heart problem-causing protein (troponin) at the peak (5. There is a statistically significant 1.8-fold (2 ng/mL versus seven ng/mL) decline in serum lysozyme levels in the group administered rhG-CSF. The treatment group exhibited a substantial increase in haemoglobin levels (t(12) = 3. 74, p-value <0.005) with a mean difference of 0. 5 ± 2 ng/mL. 001, 95% CI: 2. 1 to 3. 5). Conclusion: It is concluded that nicorandil shows positive results for the efficacy (the ability of a drug to bring the desired effect) and safety of the drug in reducing myocardial injury and in maintaining the function of myocardial during percutaneous coronary intervention in patients.

Downloads

Download data is not yet available.

References

Ye Z, Su Q, Li L. The clinical effect of nicorandil on perioperative myocardial protection in patients undergoing elective PCI: a systematic review and meta-analysis. Scientific Reports. 2017;7(1):45117.

Ye Z, Lu H, Su Q, Long M, Li L. Efficacy and safety of nicorandil on perioperative myocardial injury in patients undergoing elective percutaneous coronary intervention: results of the PENMIPCI trial. Drug Design, Development and Therapy. 2018:2591-9.

Lu Y, Hu W, Song Q, Wang Q. The efficacy and safety of nicorandil for periprocedural myocardial injury in patients undergoing PCI: a meta-analysis. Journal of Interventional Cardiology. 2020;2020.

Li J, Xu X, Zhou X, Dai J, Ma L, Chen C, et al. Cardiovascular events associated with nicorandil administration before primary percutaneous coronary intervention in patients with acute ST-segment elevated myocardial infarction: a systematic review and meta-analysis. Expert Opinion on Drug Safety. 2019;18(6):537-47.

Zhu H, Xu X, Fang X, Zheng J, Chen T, Huang J. Effects of mitochondrial ATP-sensitive potassium channel activation (nicorandil) in patients with angina pectoris undergoing elective percutaneous coronary interventions: a meta-analysis of randomized controlled trials. Medicine. 2019;98(3):e14165.

Ito S, Kitakaze M. Prevention of periprocedural myocardial injury during percutaneous coronary intervention in patients with stable coronary artery disease. Circulation Journal. 2018;82(7):1746-8.

Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. bmj. 2019;366.

Ejiri K, Miyoshi T, Kohno K, Nakahama M, Doi M, Munemasa M, et al. Protective Effect of Remote Ischemic Preconditioning on Myocardial Damage After Percutaneous Coronary Intervention in Stable Angina Patients With Complex Coronary Lesions―Subanalysis of a Randomized Controlled Trial―. Circulation Journal. 2018;82(7):1788-96.

Feng C, Liu Y, Wang L, Niu D, Han B. Effects of early intracoronary administration of nicorandil during percutaneous coronary intervention in patients with acute myocardial infarction. Heart, Lung and Circulation. 2019;28(6):858-65.

Kawakita N, Ejiri K, Miyoshi T, Kohno K, Nakahama M, Doi M, et al. Protective effect of nicorandil on myocardial injury following percutaneous coronary intervention in older patients with stable coronary artery disease: Secondary analysis of a randomized, controlled trial (RINC). PLoS One. 2018;13(4):e0194623.

Wang S, Duan Y, Feng X, Liu L, Shi Z, Wang B, et al. Sustained nicorandil administration reduces the infarct size in ST-segment elevation myocardial infarction patients with primary percutaneous coronary intervention Introduction. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi. 2019;21(3).

Zhang X, Yu Q, Yao X, Liu G, Li J, Du L. Effects of Nicorandil on All-Cause Mortality and Cardiac Events in CAD Patients Receiving PCI A Systematic Review and Meta-Analysis. International Heart Journal. 2019;60(4):886-98.

Yi B, Luo J, Jiang Y, Mo S, Xiao X, Chen X, et al. Nicorandil for periprocedural myocardial injury in elective percutaneous coronary intervention: a meta-analysis of 10 randomized controlled trials. Angiology. 2020;71(7):609-15.

Akbari B, Ghaffari S, Aslanabadi N, Sohrabi B, Pourafkari L, Akbarzadeh F, et al. The impact of oral nicorandil pre-treatment on ST resolution and clinical outcome of patients with acute ST-segment elevation myocardial infarction undergoing primary coronary angioplasty: A randomized placebo controlled trial. Journal of Cardiovascular and Thoracic Research. 2020;12(2):90.

Soboleva G, Gostishev R, Rogoza A, Kotkina T, Samko A, Soboleva T, et al. Pharmacological preconditioning by Nicorandil in prevention of ischaemic myocardial injury during an elective percutaneous coronary intervention. European Heart Journal. 2020;41(Supplement_2):ehaa946. 1463.

Wang C, Chen W, Yu M, Yang P. Efficacy of trimetazidine in limiting periprocedural myocardial injury in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis. Angiology. 2021;72(6):511-23.

Yi B, Mo S, Jiang Y, Yi D, Luo J, Chen X, et al. Efficacy and safety of nicorandil in preventing contrast-induced nephropathy after elective percutaneous coronary intervention: a pooled analysis of 1229 patients. Journal of Interventional Cardiology. 2020;2020.

Sato S, Takahashi M, Mikamo H, Kawazoe M, Iizuka T, Shimizu K, et al. Effect of nicorandil administration on cardiac burden and cardio-ankle vascular index after coronary intervention. Heart and Vessels. 2020;35(12):1664-71.

Peng Y-W, Major T, Deatrick KB, Mohammed A, Jeakle M, Charpie JR. Nicorandil attenuates ventricular dysfunction and organ injury after cardiopulmonary bypass. International Journal of Cardiology. 2022;368:62-8.

Downloads

Published

2024-05-09

How to Cite

SHAH, S., KHAN, S., & KHAN, M. (2024). EFFICACY AND SAFETY OF NICORANDIL FOR PERIPROCEDURAL MYOCARDIAL INJURY IN PATIENTS UNDERGOING PCI. Biological and Clinical Sciences Research Journal, 2024(1), 835. https://doi.org/10.54112/bcsrj.v2024i1.835

Most read articles by the same author(s)

1 2 > >>