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Published in: Heart and Vessels 12/2020

01-12-2020 | Nicorandil | Original Article

Effect of nicorandil administration on cardiac burden and cardio-ankle vascular index after coronary intervention

Authors: Shuji Sato, Mao Takahashi, Hiroshi Mikamo, Masayo Kawazoe, Takuo Iizuka, Kazuhiro Shimizu, Mahito Noro, Kohji Shirai

Published in: Heart and Vessels | Issue 12/2020

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Abstract

Myocardial injury is a problem associated with percutaneous coronary intervention (PCI). This study aimed to clarify the role of nicorandil administration in preventing myocardial injury. This study included patients with stable angina who underwent PCI from November 2013 to June 2016. Of 58 consecutive patients, the first 20 patients received only saline infusion after PCI (control group); the other 38 patients received a continuous intravenous infusion of nicorandil and saline after PCI (nicorandil group). Troponin I and brain natriuretic peptide (BNP) levels were measured. Vascular parameters, such as blood pressure (BP), cardiac output, cardio-ankle vascular index (CAVI), and estimated systemic vascular resistance (eSVR), were measured. Troponin I of both groups increased 12 h after PCI. Changes in BNP levels between immediately after PCI and 12 h after PCI were significantly higher in the control than in the nicorandil group (10.8 ± 44.2 vs. − 2.6 ± 14.6 pg/ml, p = 0.04). In the nicorandil group, BP, eSVR, and CAVI decreased significantly at 12 h after PCI compared with those immediately after PCI (p < 0.0001), whereas no change was observed in the control group. In a single linear analysis, the change in BP (r = 0.36, p < 0.01) and nicorandil administration (r = − 0.47, p < 0.001) was significantly correlated with the change in CAVI, multiple regression analysis revealed that the changes in CO and eSVR were significant contributing factors for the changes in CAVI. PCI could result in myocardial injury and/or cardiac burden in patients with stable angina. Nicorandil administration after PCI may be effective in relieving the burden by decreasing arterial stiffness (CAVI).
Literature
2.
go back to reference Gada H, Kirtane AJ, Newman W, Hermiller JB, Mahaffey KW, Cutlip DE, Sudhir K, Hou L, Koo K, Stone GW (2013) 5-year results of a randomized comparison of XIENCE V everolimus-eluting and TAXUS paclitaxel-eluting stents: final results from the SPIRIT III Trial (clinical evaluation of the XIENCE V everolimus eluting coronary stent system in the treatment of patients with de novo native coronary artery lesions). JACC Cardiovasc Interv 6:1263–1266CrossRefPubMed Gada H, Kirtane AJ, Newman W, Hermiller JB, Mahaffey KW, Cutlip DE, Sudhir K, Hou L, Koo K, Stone GW (2013) 5-year results of a randomized comparison of XIENCE V everolimus-eluting and TAXUS paclitaxel-eluting stents: final results from the SPIRIT III Trial (clinical evaluation of the XIENCE V everolimus eluting coronary stent system in the treatment of patients with de novo native coronary artery lesions). JACC Cardiovasc Interv 6:1263–1266CrossRefPubMed
3.
go back to reference Jensen LO, Thayssen P, Christiansen EH, Maeng M, Ravkilde J, Hansen KN, Hansen HS, Krusell L, Kaltoft A, Tilsted HH, Berencsi K, Junker A, Lassen JF, SORTOUTIV Investigators (2016) Safety and efficacy of everolimus-versus sirolimus-eluting stents: 5-year results from SORT OUT IV. J Am Coll Cardiol 67:751–762CrossRefPubMed Jensen LO, Thayssen P, Christiansen EH, Maeng M, Ravkilde J, Hansen KN, Hansen HS, Krusell L, Kaltoft A, Tilsted HH, Berencsi K, Junker A, Lassen JF, SORTOUTIV Investigators (2016) Safety and efficacy of everolimus-versus sirolimus-eluting stents: 5-year results from SORT OUT IV. J Am Coll Cardiol 67:751–762CrossRefPubMed
4.
go back to reference Leon MB, Baim DS, Popma JJ, Gordon PC, Cutlip DE, Ho KK, Giambartolomei A, Diver DJ, Lasorda DM, Williams DO, Pocock SJ, Kuntz RE (1998) A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis Study Investigators. N Engl J Med 339:1665–1671CrossRefPubMed Leon MB, Baim DS, Popma JJ, Gordon PC, Cutlip DE, Ho KK, Giambartolomei A, Diver DJ, Lasorda DM, Williams DO, Pocock SJ, Kuntz RE (1998) A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis Study Investigators. N Engl J Med 339:1665–1671CrossRefPubMed
5.
go back to reference Boden WE, O'Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GB, Weintraub WS, COURAGE Trial Research Group (2007) Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 356(1503):1516 Boden WE, O'Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GB, Weintraub WS, COURAGE Trial Research Group (2007) Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 356(1503):1516
6.
go back to reference Iqbal J, Zhang YJ, Holmes DR, Morice MC, Mack MJ, Kappetein AP, Feldman T, Stahle E, Escaned J, Banning AP, Gunn JP, Colombo A, Steyerberg EW, Mohr FW, Serruys PW (2015) Optimal medical therapy improves clinical outcomes in patients undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting: insights from the Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial at the 5-year follow-up. Circulation 131:1269–1277CrossRefPubMed Iqbal J, Zhang YJ, Holmes DR, Morice MC, Mack MJ, Kappetein AP, Feldman T, Stahle E, Escaned J, Banning AP, Gunn JP, Colombo A, Steyerberg EW, Mohr FW, Serruys PW (2015) Optimal medical therapy improves clinical outcomes in patients undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting: insights from the Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial at the 5-year follow-up. Circulation 131:1269–1277CrossRefPubMed
7.
go back to reference Stone GW, Sabik JF, Serruys PW, Simonton CA, Généreux P, Puskas J, Kandzari DE, Morice MC, Lembo N, Brown WM 3rd, Taggart DP, Banning A, Merkely B, Horkay F, Boonstra PW, van Boven AJ, Ungi I, Bogáts G, Mansour S, Noiseux N, Sabaté M, Pomar J, Hickey M, Gershlick A, Buszman P, Bochenek A, Schampaert E, Pagé P, Dressler O, Kosmidou I, Mehran R, Pocock SJ, Kappetein AP, EXCEL Trail Investigators (2016) Everolimus-eluting stents or bypass surgery for left main coronary artery disease. N Engl J Med 375:2223–2235CrossRefPubMed Stone GW, Sabik JF, Serruys PW, Simonton CA, Généreux P, Puskas J, Kandzari DE, Morice MC, Lembo N, Brown WM 3rd, Taggart DP, Banning A, Merkely B, Horkay F, Boonstra PW, van Boven AJ, Ungi I, Bogáts G, Mansour S, Noiseux N, Sabaté M, Pomar J, Hickey M, Gershlick A, Buszman P, Bochenek A, Schampaert E, Pagé P, Dressler O, Kosmidou I, Mehran R, Pocock SJ, Kappetein AP, EXCEL Trail Investigators (2016) Everolimus-eluting stents or bypass surgery for left main coronary artery disease. N Engl J Med 375:2223–2235CrossRefPubMed
8.
go back to reference Escaned J, Collet C, Ryan N, De Maria GL, Walsh S, Sabate M, Davies J, Lesiak M, Moreno R, Cruz-Gonzalez I, Hoole SP, Ej West N, Piek JJ, Zaman A, Fath-Ordoubadi F, Stables RH, Appleby C, van Mieghem N, van Geuns RJ, Uren N, Zueco J, Buszman P, Iñiguez A, Goicolea J, Hildick-Smith D, Ochala A, Dudek D, Hanratty C, Cavalcante R, Kappetein AP, Taggart DP, van Es GA, Morel MA, de Vries T, Onuma Y, Farooq V, Serruys PW, Banning AP (2017) Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II Study. Eur Heart J 38:3124–3134CrossRefPubMedPubMedCentral Escaned J, Collet C, Ryan N, De Maria GL, Walsh S, Sabate M, Davies J, Lesiak M, Moreno R, Cruz-Gonzalez I, Hoole SP, Ej West N, Piek JJ, Zaman A, Fath-Ordoubadi F, Stables RH, Appleby C, van Mieghem N, van Geuns RJ, Uren N, Zueco J, Buszman P, Iñiguez A, Goicolea J, Hildick-Smith D, Ochala A, Dudek D, Hanratty C, Cavalcante R, Kappetein AP, Taggart DP, van Es GA, Morel MA, de Vries T, Onuma Y, Farooq V, Serruys PW, Banning AP (2017) Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II Study. Eur Heart J 38:3124–3134CrossRefPubMedPubMedCentral
9.
go back to reference Zeitouni M, Silvain J, Guedeney P, Kerneis M, Yan Y, Overtchouk P, Barthelemy O, Hauguel-Moreau M, Choussat R, Helft G, Le Feuvre C, Collet JP, Montalescot G, ACTION Study Group (2018) Periprocedural myocardial infarction and injury in elective coronary stenting. Eur Heart J 39(1100):1109 Zeitouni M, Silvain J, Guedeney P, Kerneis M, Yan Y, Overtchouk P, Barthelemy O, Hauguel-Moreau M, Choussat R, Helft G, Le Feuvre C, Collet JP, Montalescot G, ACTION Study Group (2018) Periprocedural myocardial infarction and injury in elective coronary stenting. Eur Heart J 39(1100):1109
10.
11.
go back to reference The IONA study group (2002) Effect of nicorandil on coronary events in patients with stable angina: the Impact Of Nicorandil in Angina (IONA) randomized trial. Lancet 359:1269–1275CrossRef The IONA study group (2002) Effect of nicorandil on coronary events in patients with stable angina: the Impact Of Nicorandil in Angina (IONA) randomized trial. Lancet 359:1269–1275CrossRef
12.
go back to reference Ito H, Taniyama Y, Iwakura K, Nishikawa N, Masuyama T, Kuzuya T, Hori M, Higashino Y, Fujii K, Minamino T (1999) Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol 33:654–660CrossRefPubMed Ito H, Taniyama Y, Iwakura K, Nishikawa N, Masuyama T, Kuzuya T, Hori M, Higashino Y, Fujii K, Minamino T (1999) Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol 33:654–660CrossRefPubMed
13.
go back to reference Minami Y, Nagashima M, Kajimoto K, Shiga T, Hagiwara N (2009) Acute efficacy and safety of intravenous administration of nicorandil in patients with acute heart failure syndromes: usefulness of noninvasive echocardiographic hemodynamic evaluation. J Cardiovasc Pharmacol 54:335–340CrossRefPubMed Minami Y, Nagashima M, Kajimoto K, Shiga T, Hagiwara N (2009) Acute efficacy and safety of intravenous administration of nicorandil in patients with acute heart failure syndromes: usefulness of noninvasive echocardiographic hemodynamic evaluation. J Cardiovasc Pharmacol 54:335–340CrossRefPubMed
14.
go back to reference Tanaka K, Kato K, Takano T, Katagiri T, Asanoi H, Nejima J, Nakashima M, Kamijo T, Sakanashi M (2010) Acute effects of intravenous nicorandil on hemodynamics in patients hospitalized with acute decompensated heart failure. J Cardiol 56:291–299CrossRefPubMed Tanaka K, Kato K, Takano T, Katagiri T, Asanoi H, Nejima J, Nakashima M, Kamijo T, Sakanashi M (2010) Acute effects of intravenous nicorandil on hemodynamics in patients hospitalized with acute decompensated heart failure. J Cardiol 56:291–299CrossRefPubMed
15.
go back to reference Troughton R, Michael Felker G, Januzzi JL Jr (2014) Natriuretic peptide-guided heart failure management. Eur Heart J 35:16–24CrossRefPubMed Troughton R, Michael Felker G, Januzzi JL Jr (2014) Natriuretic peptide-guided heart failure management. Eur Heart J 35:16–24CrossRefPubMed
16.
go back to reference Pandey A, Khan H, Newman AB, Lakatta EG, Forman DE, Butler J, Berry JD (2017) Arterial stiffness and risk of overall heart failure, heart failure with preserved ejection fraction, and heart failure with reduced ejection fraction: the Health ABC Study (health, aging, and body composition). Hypertension 69:267–274CrossRefPubMed Pandey A, Khan H, Newman AB, Lakatta EG, Forman DE, Butler J, Berry JD (2017) Arterial stiffness and risk of overall heart failure, heart failure with preserved ejection fraction, and heart failure with reduced ejection fraction: the Health ABC Study (health, aging, and body composition). Hypertension 69:267–274CrossRefPubMed
17.
go back to reference Shirai K, Utino J, Otsuka K, Takata M (2006) A novel blood pressure-independent arterial wall stiffness parameter: cardio-ankle vascular index (CAVI). J Atheroscler Thromb 13:101–107CrossRefPubMed Shirai K, Utino J, Otsuka K, Takata M (2006) A novel blood pressure-independent arterial wall stiffness parameter: cardio-ankle vascular index (CAVI). J Atheroscler Thromb 13:101–107CrossRefPubMed
18.
go back to reference Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, Miyashita Y, Saiki A, Takahashi M, Suzuki K, Takata M (2011) Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb 18:924–938CrossRefPubMed Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, Miyashita Y, Saiki A, Takahashi M, Suzuki K, Takata M (2011) Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb 18:924–938CrossRefPubMed
19.
go back to reference Shirai K, Song M, Suzuki J, Kurosu T, Oyama T, Nagayama D, Miyashita Y, Yamamura S, Takahashi M (2011) Contradictory effects of β1- and α1-adrenergic receptor blockers on cardio-ankle vascular stiffness index (CAVI): CAVI is independent of blood pressure. J Atheroscler Thromb 18:49–55CrossRefPubMed Shirai K, Song M, Suzuki J, Kurosu T, Oyama T, Nagayama D, Miyashita Y, Yamamura S, Takahashi M (2011) Contradictory effects of β1- and α1-adrenergic receptor blockers on cardio-ankle vascular stiffness index (CAVI): CAVI is independent of blood pressure. J Atheroscler Thromb 18:49–55CrossRefPubMed
20.
go back to reference Takahashi M, Shiba T, Hirano K, Hitsumoto T, Shirai K (2012) Acute decrease of cardio-ankle vascular index with the administration of beraprost sodium. J Atheroscler Thromb 19:479–484CrossRefPubMed Takahashi M, Shiba T, Hirano K, Hitsumoto T, Shirai K (2012) Acute decrease of cardio-ankle vascular index with the administration of beraprost sodium. J Atheroscler Thromb 19:479–484CrossRefPubMed
21.
go back to reference Shimizu K, Yamamoto T, Takahashi M, Sato S, Noike H, Shirai K (2016) Effect of nitroglycerin administration on cardio-ankle vascular index. Vasc Health Risk Manag 12:313–319CrossRefPubMedPubMedCentral Shimizu K, Yamamoto T, Takahashi M, Sato S, Noike H, Shirai K (2016) Effect of nitroglycerin administration on cardio-ankle vascular index. Vasc Health Risk Manag 12:313–319CrossRefPubMedPubMedCentral
22.
go back to reference Chiba T, Yamanaka M, Takagi S, Shimizu K, Takahashi M, Shirai K, Takahara A (2015) Cardio-ankle vascular index (CAVI) differentiates pharmacological properties of vasodilators nicardipine and nitroglycerin in anesthetized rabbits. J Pharmacol Sci 128:185–192CrossRefPubMed Chiba T, Yamanaka M, Takagi S, Shimizu K, Takahashi M, Shirai K, Takahara A (2015) Cardio-ankle vascular index (CAVI) differentiates pharmacological properties of vasodilators nicardipine and nitroglycerin in anesthetized rabbits. J Pharmacol Sci 128:185–192CrossRefPubMed
23.
go back to reference Kasama S, Toyama T, Iwasaki T, Sumino H, Kumakura H, Minami K, Ichikawa S, Matsumoto N, Sato Y, Kurabayashi M (2014) Effects of oral nicorandil therapy on sympathetic nerve activity and cardiac events in patients with chronic heart failure: subanalysis of our previous report using propensity score matching. Eur J Nucl Med Mol Imaging 41:144–154CrossRefPubMed Kasama S, Toyama T, Iwasaki T, Sumino H, Kumakura H, Minami K, Ichikawa S, Matsumoto N, Sato Y, Kurabayashi M (2014) Effects of oral nicorandil therapy on sympathetic nerve activity and cardiac events in patients with chronic heart failure: subanalysis of our previous report using propensity score matching. Eur J Nucl Med Mol Imaging 41:144–154CrossRefPubMed
24.
go back to reference Kasama S, Toyama T, Funada R, Takama N, Koitabashi N, Ichikawa S, Suzuki Y, Matsumoto N, Sato Y, Kurabayashi M (2015) Effects of adding intravenous nicorandil to standard therapy on cardiac sympathetic nerve activity and myocyte dysfunction in patients with acute decompensated heart failure. Eur J Nucl Med Mol Imaging 42:761–770CrossRefPubMed Kasama S, Toyama T, Funada R, Takama N, Koitabashi N, Ichikawa S, Suzuki Y, Matsumoto N, Sato Y, Kurabayashi M (2015) Effects of adding intravenous nicorandil to standard therapy on cardiac sympathetic nerve activity and myocyte dysfunction in patients with acute decompensated heart failure. Eur J Nucl Med Mol Imaging 42:761–770CrossRefPubMed
Metadata
Title
Effect of nicorandil administration on cardiac burden and cardio-ankle vascular index after coronary intervention
Authors
Shuji Sato
Mao Takahashi
Hiroshi Mikamo
Masayo Kawazoe
Takuo Iizuka
Kazuhiro Shimizu
Mahito Noro
Kohji Shirai
Publication date
01-12-2020
Publisher
Springer Japan
Keyword
Nicorandil
Published in
Heart and Vessels / Issue 12/2020
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-020-01650-9

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