Background: Minor cardiac marker elevation after percutaneous coronary intervention has long-term prognostic significance. We examined whether nicorandil, a nicotinamide-nitrate ester, reduces the incidence of minor cardiac marker elevation after coronary stenting.
Methods: Patients (n=192) undergoing coronary stenting were randomly assigned to receive nicorandil (nicorandil group, n=91) or vehicle (control group, n=101). Nicorandil (2 mu g/kg/min, intravenously) was administered immediately after the patients were transfer-red into the catheterization laboratory and continued for 6 h. We measured the serum concentrations of creatine kinase isoenzyme MB (CK-MB) before, immediately after, and 6, 12, and 24 h after the procedure, and those of cardiac troponin T (cTnT) 24 h after the procedure.
Results: There was no significant difference in clinical background between the 2 groups. The nicorandil group showed a significantly lower incidence of CK-MB elevation (> 1 x upper limit of control range, 20 IU/l) than the control group (8.8% vs 21.8%,p < 0.05). The levels of serum CK-MB in the nicorandil group were significantly lower than those in the control group (13.4+5.7 vs 16.5 +/- 9.7 IU/l, p < 0.01). Similarly, the nicorandil group showed a significantly lower incidence of cTnT elevation [> 1 x (0.1 ng/ml) or > 2x (0.2 ng/ml)] upper limit of control range than the control group (14.3% vs 26.7%, p < 0.05, or 7.7% vs 17.8%,p < 0.05). Serum cTnT levels were also significantly lower in the nicorandil group than in the control group (0.05 +/- 0.10 vs 0.15 +/- 0.36 ng/ml, p < 0.05).
Conclusions: The results demonstrated that nicorandil reduces minor cardiac marker elevation after coronary stenting. (c) 2005 Elsevier Ireland Ltd. All rights reserved.