Mohamed Shehata1. 1. Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
OBJECTIVE: This study sought to evaluate the cardioprotective role of oral nicorandil (a hybrid between the nitrates and adenosine triphosphate [ATP] sensitive potassium channel activators) in diabetic patients undergoing elective percutaneous coronary intervention (PCI). BACKGROUND: Myocardial injury commonly occurs during PCI. Several agents that mimic ischemic preconditioning could help minimize this phenomenon. METHODS:One hundred diabetic patients with stable angina were prospectively enrolled, then randomly assigned to receive oral nicorandil: 20 mg once daily (group A, 50 patients) or placebo (group B, 50 patients) 1 week before and 6 months after PCI. Cardiac troponin I (cTnI) andcreatine kinase-MB (CK-MB) levels were measured before and 6, 12, and 24 hours post-PCI. RESULTS:Mean age of the study cohort was 59.8 ± 5.8 years (males = 68%). cTnI level was significantly lower in group A (6 hours: 7.3 ± 0.3 vs. 14.5 ± 0.4 pg/mL; 12 hours: 12.7 ± 0.7 vs. 25.3 ± 0.5 pg/mL; and 24 hours: 7.7 ± 0.5 vs. 15.0 ± 0.4 pg/mL, P < 0.001). After 6 months, the same group showed significantly higher left ventricle ejection fraction (LVEF%), that is, 63.5 ± 7.7% versus 56.5 ± 8.3% (P < 0.05), with a trend toward lower incidence of major adverse cardiac events (MACE). CONCLUSION: In diabetic patients undergoingelective PCI, nicorandil intake was associated with decreased incidence of PCI-related myocardial injury and improvement of LVEF% after 6 months.
RCT Entities:
OBJECTIVE: This study sought to evaluate the cardioprotective role of oral nicorandil (a hybrid between the nitrates and adenosine triphosphate [ATP] sensitive potassium channel activators) in diabeticpatients undergoing elective percutaneous coronary intervention (PCI). BACKGROUND:Myocardial injury commonly occurs during PCI. Several agents that mimic ischemic preconditioning could help minimize this phenomenon. METHODS: One hundred diabeticpatients with stable angina were prospectively enrolled, then randomly assigned to receive oral nicorandil: 20 mg once daily (group A, 50 patients) or placebo (group B, 50 patients) 1 week before and 6 months after PCI. Cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) levels were measured before and 6, 12, and 24 hours post-PCI. RESULTS: Mean age of the study cohort was 59.8 ± 5.8 years (males = 68%). cTnI level was significantly lower in group A (6 hours: 7.3 ± 0.3 vs. 14.5 ± 0.4 pg/mL; 12 hours: 12.7 ± 0.7 vs. 25.3 ± 0.5 pg/mL; and 24 hours: 7.7 ± 0.5 vs. 15.0 ± 0.4 pg/mL, P < 0.001). After 6 months, the same group showed significantly higher left ventricle ejection fraction (LVEF%), that is, 63.5 ± 7.7% versus 56.5 ± 8.3% (P < 0.05), with a trend toward lower incidence of major adverse cardiac events (MACE). CONCLUSION: In diabeticpatients undergoing elective PCI, nicorandil intake was associated with decreased incidence of PCI-related myocardial injury and improvement of LVEF% after 6 months.
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