ArticleClinical research in cardiology : official journal of the German Cardiac Society2025
Impact of oral nicorandil administration prior to primary percutaneous coronary intervention on no-reflow: a randomized controlled trial.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
1 citing paper in PubMed.
- Intracoronary nicorandil improves coronary microcirculatory function after primary PCI in first-episode STEMI: an angiography-derived evaluation using AMR and QFR.Frontiers in cardiovascular medicine · 2026Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundPrior studies and meta-analyses showed cardioprotective benefits of intravenous or intracoronary nicorandil administration in ST-segment elevation myocardial infarction (STEMI). However, little is known about the efficacy of oral nicorandil in this context, especially that parenteral forms are not widely available.
aimTo investigate the impact of oral nicorandil administered before primary percutaneous coronary intervention (PPCI) on no-reflow and to assess the in-hospital and 3-month major adverse cardiac events (MACE).
methodsA total of 302 patients with STEMI undergoing PPCI were randomly assigned in a 1:1 fashion to the Nicorandil-group, who received pre-PPCI oral nicorandil 20 mg followed by maintenance 20 mg b.i.d. for 3 months, and the Control-group. The primary endpoint was no-reflow defined as TIMI flow ≤ 2. Secondary endpoints included myocardial blush grade (MBG), ST-segment resolution, electrocardiographic repolarization dispersion, and in-hospital and 3-month MACE. Baseline and follow-up echocardiography were performed. A 3-month cardiac magnetic resonance (CMR) was performed in a subset of 50 patients.
resultsNicorandil-group showed significantly lower rates of no-reflow (11.9% vs 24.5%, p = 0.005), better MBG, higher rates of complete ST-resolution, and better indices of repolarization dispersion compared to the Control-group. Pre-PPCI nicorandil was among the independent protectors against no-reflow (OR = 0.43, 95%CI = 0.23-0.81, p = 0.01). The Nicorandil-group demonstrated significantly better LV function and lower MACE at follow-up. Three-month CMR data showed microvascular obstruction in two patients among the Control-group and none among the Nicorandil-group (p = 0.14).
conclusionOral nicorandil was associated with post-PPCI lower rates of no-reflow and improved myocardial reperfusion. Moreover, it showed improved LVEF and reduced MACE at 3 months.
Indexed as
Identifiers
40839018What Socratic holds
Registered trials
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