T Kato1, T Kamiyama, Y Maruyama, S Tanaka, N Yoshimoto. 1. Third Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan. torumed3@saitama-med.ac.jp
Abstract
BACKGROUND: Previous studies have found that ST-segment elevation and QT dispersion are smaller in second coronary occlusions than in first occlusions, a trend that suggests ischemic preconditioning. It has not been established whether nicorandil reduces ST-segment elevation and QT dispersion during coronary angioplasty. METHODS AND RESULTS:Thirty patients with stable angina undergoing coronary angioplasty in the proximal left anterior descending artery were randomly assigned to one of two groups, receiving either 5 mg oral nicorandil 3 times daily (n = 15) or placebo (n = 15). In the control patients, the total ST-segment elevation decreased from 14 +/- 3 mm during the first inflation to 7 +/- 2 mm during the second inflation (P < .01). In contrast, in the nicorandil-treated patients, the total ST-segment elevation during the second inflation was roughly equivalent to that during the first inflation (8 +/- 3 mm vs 8 +/- 3 mm, P = not significant). After the first reperfusion, a significantly smaller increase in QT dispersion was observed in the nicorandil-treated patients than in the control patients (43 +/- 15 ms vs 54 +/- 15 ms, P < .001). However, after the second reperfusion, QT dispersion was similar for the two groups (32 +/- 15 ms vs 34 +/- 13 ms, P = not significant). CONCLUSIONS:Nicorandil may precondition the myocardium and may prevent the occurrence of ventricular arrhythmias after coronary reperfusion by suppressing the increase in QT dispersion.
RCT Entities:
BACKGROUND: Previous studies have found that ST-segment elevation and QT dispersion are smaller in second coronary occlusions than in first occlusions, a trend that suggests ischemic preconditioning. It has not been established whether nicorandil reduces ST-segment elevation and QT dispersion during coronary angioplasty. METHODS AND RESULTS: Thirty patients with stable angina undergoing coronary angioplasty in the proximal left anterior descending artery were randomly assigned to one of two groups, receiving either 5 mg oral nicorandil 3 times daily (n = 15) or placebo (n = 15). In the control patients, the total ST-segment elevation decreased from 14 +/- 3 mm during the first inflation to 7 +/- 2 mm during the second inflation (P < .01). In contrast, in the nicorandil-treated patients, the total ST-segment elevation during the second inflation was roughly equivalent to that during the first inflation (8 +/- 3 mm vs 8 +/- 3 mm, P = not significant). After the first reperfusion, a significantly smaller increase in QT dispersion was observed in the nicorandil-treated patients than in the control patients (43 +/- 15 ms vs 54 +/- 15 ms, P < .001). However, after the second reperfusion, QT dispersion was similar for the two groups (32 +/- 15 ms vs 34 +/- 13 ms, P = not significant). CONCLUSIONS:Nicorandil may precondition the myocardium and may prevent the occurrence of ventricular arrhythmias after coronary reperfusion by suppressing the increase in QT dispersion.
Authors: Weiding Wang; Xu Zhang; Kangyin Chen; Li Yin; Mengqi Gong; Yang Liu; Gary Tse; Lin Wu; Guangping Li; Tong Liu Journal: Ann Noninvasive Electrocardiol Date: 2019-12-17 Impact factor: 1.468