High Index of Microcirculatory Resistance Level After Successful Primary Percutaneous Coronary Intervention Can Be Improved by Intracoronary Administration of Nicorandil

Background: Although microvascular dysfunction following percutaneous coronary intervention (PCI) can be evaluated with the index of microcirculatory resistance (IMR), no method of treatment has been established. We hypothesized that intracoronary administration of nicorandil can improve IMR after s...

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Published in:Circulation Journal 2010, Vol.74(5), pp.909-915
Main Authors: Ito, Noritoshi, Nanto, Shinsuke, Doi, Yasuji, Sawano, Hirotaka, Masuda, Daisaku, Yamashita, Shizuya, Okada, Ken-ichiro, Kaibe, Shoji, Hayashi, Yasuyuki, Kai, Tatsuro, Hayashi, Toru
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Aged
Anti-Arrhythmia Agents - administration & dosage
Catheter Ablation
Female
Humans
Index of microcirculatory resistance
Male
Microcirculation
Microcirculation - drug effects
Middle Aged
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Nicorandil
Nicorandil - administration & dosage
Prospective Studies
Vascular Resistance - drug effects
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Summary:Background: Although microvascular dysfunction following percutaneous coronary intervention (PCI) can be evaluated with the index of microcirculatory resistance (IMR), no method of treatment has been established. We hypothesized that intracoronary administration of nicorandil can improve IMR after successful primary PCI in patients with ST-segment elevation myocardial infarction (STEMI). Methods and Results: In 40 patients with first STEMI after successful primary PCI, IMR was measured using PressureWireTM Certus (St. Jude Medical, MN, USA). In 20 of the patients (Group N), IMR was measured at baseline and after intracoronary nicorandil (2 mg/10 ml). In the other 20 patients (Control), IMR was measured at baseline, after intracoronary saline (10 ml) and after intracoronary nicorandil (2 mg/10 ml). In Group N, IMR significantly decreased after intracoronary nicorandil (median IMR, 27.7-18.7 U, P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-09-0943