Nicorandil reduces the incidence of minor cardiac marker elevation after coronary stenting
Nicorandil reduces the incidence of minor cardiac marker elevation after coronary stenting
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DOI：
10.1016/j.ijcard.2005.02.034
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发表时间：
2006-02-08
影响因子：
3.5
通讯作者：
Shiratori, Y
中科院分区：
文献类型：
--
作者：
Murakami, M;Iwasaki, K;Shiratori, Y
背景：经皮冠状动脉介入治疗后心脏标志物轻微升高具有长期预后意义。我们研究了尼可地尔，一种烟酰胺硝酸酯，是否能降低冠状动脉支架植入术后轻微心脏标志物升高的发生率。方法：接受冠状动脉支架植入术的患者（n = 192）被随机分配接受尼可地尔（尼可地尔组，n = 91）或车辆（对照组，n = 101）。患者转入导管室后立即给予尼可地尔（2 μ g/kg/min，静脉注射），并持续6 h。分别于术前、术后即刻、术后6、12、24 h测定血清肌酸激酶同工酶MB（CK-MB）浓度，术后24 h测定血清心肌肌钙蛋白T（cTnT）浓度。尼可地尔组显示CK-MB升高的发生率（> 1 x控制范围上限，20 IU/l）显著低于对照组（8.8% vs 21.8%，p <0.05）。尼可地尔组的血清CK-MB水平显著低于对照组（13.4 ± 5.7 vs 16.5 ± 9.7 IU/l，p <0.01）。同样，尼可地尔组cTnT升高[> 1 x（0.1 ng/ml）或> 2 x（0.2 ng/ml）]控制范围上限的发生率显著低于对照组（14.3% vs 26.7%，p <0.05，或7.7% vs 17.8%，p <0.05）。尼可地尔组的血清cTnT水平也显著低于对照组（0.05 +/-0.10 vs 0.15 +/-0.36 ng/ml，p <0.05）。结论：结果表明，尼可地尔可降低冠状动脉支架植入术后轻微的心脏标志物升高。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
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.