ABSTRACT
Objective To explore the effects of nicorandil on cardiac function and clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Method Sixty-six patients with AMI were randomized into a control group and nicorandil group (n = 33 for each group). In the nicorandil group, nicorandil (4 mg as a bolus injection followed by constant infusion at 8 mg/hour for 24 hours) was administered immediately after admission. Reactive oxygen species (ROS) formation was assessed by measuring urinary excretion of 8-epi-prostaglandin F2α (PGF2α) and compared between the two groups; cardiac function and cardiac events were also compared. Results Urinary 8-epi-PGF2αexcretion was increased 2-fold at 60 to 90 minutes after PCI in the control group, whereas it was unchanged in the nicorandil group (P < 0.001). Left ventricular ejection fraction and cardiac index immediately after PCI and at 6 months were greater in the nicorandil group than in the control group(P < 0.05). Rates of total inhospital cardiac events and rehospitalization were lower in the nicorandil group than in the control group (P<0.05). Conclusions Nicorandil improves cardiac function and clinical outcomes in patients with AMI undergoing primary percutaneous coronary intervention. Suppression of ROS formation may be involved in the potential mechanism.