Abstract:
BACKGROUND:The potential exists for microcirculatory impairment during rotational coronary atherectomy (RA) due to embolization of plaque debris, platelet aggregation, or vasospasm. This prospective randomized pilot study aimed to confirm favorable effects of nicorandil during RA compared with verapamil. METHODS:We randomly assigned 200 patients with 219 coronary lesions planned to undergo RA with intracoronary infusion of nicorandil cocktail (100 patients, 109 lesions), which contained nicorandil 24 mg, nitroglycerin 5 mg, and heparin 10,000 U in 1000 mL saline, or verapamil cocktail (100 patients, 110 lesions), which contained verapamil 10 mg instead of nicorandil. Drug cocktails were infused through a 4F Teflon sheath of the rotablator system during RA. The primary end point was incidence of no-reflow/slow-flow phenomenon; secondary end points were those of continuous ST elevation, Q-wave myocardial infarction (MI), and non-Q-wave MI. RESULTS:Group baseline and coronary angiographic characteristics were similar. Rotational atherectomy was performed successfully, and no patients died or required emergency coronary artery bypass grafting. Incidence of no-reflow/slow-flow phenomenon was significantly lower in the nicorandil group (nicorandil 5/109 lesions, verapamil 13/110 lesions, P < .005). Incidences of persistent ST-segment elevation and non-Q-wave MI were significantly lower in the nicorandil group (ST-segment elevation: nicorandil 3/100 patients, verapamil 10/100 patients, P < .05; non-Q-wave MI: nicorandil 2/100, verapamil 9/100 patients, P < .05). One patient each in the 2 groups experienced Q-wave MI. CONCLUSION:Our findings suggest that continuous intracoronary infusion of nicorandil during RA prevents acute periprocedural complications. Nicorandil should be used as adjunctive treatment during RA.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Matsuo H,Watanabe S,Watanabe T,Warita S,Kojima T,Hirose T,Iwama M,Ono K,Takahashi H,Segawa T,Minatoguchi S,Fujiwara Hdoi
10.1016/j.ahj.2007.07.036subject
Has Abstractpub_date
2007-11-01 00:00:00pages
994.e1-6issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(07)00619-9journal_volume
154pub_type
杂志文章,随机对照试验abstract::The expansion of antiarrhythmic therapy beyond pharmacologic agents to include surgery, devices, and ablation procedures, plus the reaffirmation by the Cardiac Arrhythmia Suppression Trial (CAST) of the need for concurrent placebo-controlled trials to establish a mortality benefit, have resulted in the need to conside...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(94)90097-3
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Case fatality rates after acute myocardial infarction (MI) have decreased markedly over the last 3 decades. Some subgroups may have benefited more than others, but this hypothesis has not been evaluated in a large nationally representative cohort. Accordingly, we sought to assess long-term temporal trends in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.04.009
更新日期:2008-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2004.10.025
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journal_title:American heart journal
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pub_type: 临床试验,杂志文章
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更新日期:1987-09-01 00:00:00
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journal_title:American heart journal
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,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:American heart journal
pub_type: 杂志文章
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更新日期:1981-08-01 00:00:00
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更新日期:1992-04-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1983-09-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2014.12.022
更新日期:2015-04-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2003-04-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:1986-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1984-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:2014-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:1986-08-01 00:00:00