Intracoronary administration of nicorandil during primary percutaneous coronary intervention: Impact on restoration of regional myocardial perfusion in reperfused myocardium during the subacute phase of myocardial infarction

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URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/28735
Title
Intracoronary administration of nicorandil during primary percutaneous coronary intervention: Impact on restoration of regional myocardial perfusion in reperfused myocardium during the subacute phase of myocardial infarction
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Description

Abstract
BACKGROUND:

The impact of nicorandil as adjunctive therapy for percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) is controversial. We performed 15O-labeled water positron emission tomography (PET) to quantify regional myocardial perfusion in patients with STEMI who received nicorandil or no adjunctive therapy during PCI.
METHODS:

PCI was performed within 8 h after STEMI onset in 33 patients. 14 patients received intracoronary nicorandil 2 mg immediately after recanalization of the culprit lesion (Nico group). After 3-4 weeks, PET was performed in which myocardial blood flow (MBF) was measured at baseline and during adenosine triphosphate (ATP)-induced hyperemia. Myocardial vascular resistance (MVR) was calculated for all segments. Data were obtained from the reperfused (Rep) and normal segments (Cont) in each patient.
RESULTS:

In patients not given nicorandil (No-Nico group), the MBF was significantly lower in Rep than that in Cont at baseline and during hyperemia (Cont vs. Rep: 0.82 ± 0.14 vs. 0.68 ± 0.11, P = 0.001, ATP-Cont vs. ATP-Rep: 2.00 ± 0.72 vs. 1.52 ± 0.61, P = 0.017), which was restored in the Nico group (Cont vs. Rep: 0.79 ± 0.17 vs. 0.78 ± 0.20; ATP-Cont vs. ATP-Rep: 2.02 ± 0.84 vs. 1.84 ± 0.62). MVR was elevated in Rep at baseline and during hyperemia in the No-Nico group. MVR elevation in Rep was prevented in the Nico group.
CONCLUSIONS:

15O-labeled water PET was feasible for segmental analysis of MBF during the subacute phase of STEMI. It revealed that intracoronary administration of nicorandil to STEMI patients who underwent PCI prevented MVR elevation and thus restored MBF in the reperfused segments to a level similar to that in the normal segments.

(医博甲617)

Author
著者 高畠 渉
著者(ヨミ) タカバタケ ワタル
著者(別表記) Takabatake Wataru
Publication Title
International Journal of Cardiology: Heart and Vasculature
Publication Title Alternative
Int J Cardiol Heart Vasc.
Volume
8
Start Page
81
End Page
86
Publisher
Elsevier
Published Date
2015-09-01
ISSN
2352-9067
PMID
28785685
DOI
10.1016/j.ijcha.2015.05.011
Resource Type
Thesis or Dissertation
Language
eng
Relation
PMCID: PMC5497254
Resource URL
https://doi.org/10.1016/j.ijcha.2015.05.011
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497254/
Rights
Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.
この博士論文の本文については、次のエルゼビアの著作権ポリシーの規定により公開しています。「博士論文の場合は、エンバーゴ期間に関係なく機関リポジトリに出版社版を公開することができます。」 The text of this doctoral dissertation is published according to the following Elsevier copyright policy. "In the case of doctoral dissertations, publishers can be published in institutional repositories regardless of the Embargo period."
Publisher's Version: https://doi.org/10.1016/j.ijcha.2015.05.011
Text Version
ETD
Grant ID
博甲第617号
Grant Date
2015-09-29
Degree Name
博士(医学)
Grantor
香川大学
Set
香川大学
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