Effects of intravenous nicorandil before reperfusion for acute myocardial infarction in patients with stress hyperglycemia.

Abstract:

OBJECTIVE:Stress hyperglycemia increases the risk of mortality and poor outcomes in patients with acute myocardial infarction (AMI). We aimed to assess effects of intravenous nicorandil administered before reperfusion on AMI patients with stress hyperglycemia. RESEARCH DESIGN AND METHODS:This study consisted of 158 consecutive first AMI patients with stress hyperglycemia who underwent percutaneous coronary intervention (PCI) within 24 h from the onset. They were randomly assigned to receive 12 mg of nicorandil (n = 81) or a placebo (n = 77) intravenously just before reperfusion. Stress hyperglycemia was defined as a blood glucose level > or =10 mmol/l (180 mg/dl). We examined various aspects of epicardial flow and microvascular function as immediate data and major adverse cardiac events (MACEs) (coronary heart disease death or unplanned readmission due to congestive heart failure) as late-phase data. RESULTS:The incidence of slow flow after PCI was lower in the nicorandil group (13.6 vs. 27.3%, P < 0.04). ST segment resolution >50% was observed in 70.4 and 53.2% on nicorandil and placebo, respectively (P < 0.03). Patients treated with nicorandil had a lower peak creatine kinase level (3,137 +/- 2,577 vs. 4,333 +/- 3,608, P < 0.02). Upon Kaplan-Meier analysis, 5 years' freedom from MACEs was 86.4% in the nicorandil group and 74.0% in the placebo (P < 0.05). CONCLUSIONS:Adjunctive therapy with administration of intravenous nicorandil before reperfusion on AMI patients with stress hyperglycemia significantly improves epicardial flow and prevents the occurrence of severe microvascular reperfusion injury, resulting in better outcomes in these patients.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Ishii H,Ichimiya S,Kanashiro M,Amano T,Matsubara T,Murohara T

doi

10.2337/diacare.29.02.06.dc05-1588

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

202-6

issue

2

eissn

0149-5992

issn

1935-5548

pii

29/2/202

journal_volume

29

pub_type

杂志文章,随机对照试验
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    更新日期:2003-10-01 00:00:00

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    更新日期:2002-02-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/diacare.14.3.249

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    更新日期:1991-03-01 00:00:00

  • Profibrotic Circulating Proteins and Risk of Early Progressive Renal Decline in Patients With Type 2 Diabetes With and Without Albuminuria.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc20-0630

    authors: Ihara K,Skupien J,Kobayashi H,Md Dom ZI,Wilson JM,O'Neil K,Badger HS,Bowsman LM,Satake E,Breyer MD,Duffin KL,Krolewski AS

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    pub_type: 杂志文章,评审

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    pub_type: 杂志文章,评审

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    更新日期:1993-12-01 00:00:00

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    journal_title:Diabetes care

    pub_type: 杂志文章

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    pub_type: 杂志文章,多中心研究

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    journal_title:Diabetes care

    pub_type: 杂志文章

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    journal_title:Diabetes care

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    pub_type: 杂志文章

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    journal_title:Diabetes care

    pub_type: 杂志文章

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    更新日期:2008-05-01 00:00:00

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    pub_type: 杂志文章,多中心研究,随机对照试验

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    pub_type: 杂志文章,随机对照试验

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    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

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  • The prevalence and predictors of an abnormal ankle-brachial index in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial.

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    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章

    doi:10.2337/diacare.20.7.1134

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