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ARTICLEINFO ABSTRACT
Article type: Introduction: Ischemic preconditioning mediated by potassium channels
Original Article is a physiological protective mechanism. It is hypothesized that Nicorandil,
which is a potassium channel activator, could protect the heart via
Article history: preconditioning.
Received: 23 May 2016 Materials and Methods: This clinical trial was conducted on 162 patients
Revised: 6 Aug 2016 undergoing percutaneous coronary intervention (PCI) in Quem hospital,
Accepted: 17 Aug 2016 from January 2013 to January 2014,patients divided into two groups. The
first group received standard treatment plus Nicorandil (10 mg, twice
Keywords: daily) for three days before and after angioplasty. The second group
Angioplasty received standard treatment after PCI.
Nicorandil Results: Cardiac enzyme levels were significantly lower in the Nicorandil
Preconditioning group at 6 and 12 hours after angioplasty,( p value =0.001) while no
significant differences were observed in the symptoms and four-month
prognosis of the study groups(p value=0.8).
Conclusion: It is recommended that a randomized clinical trial be
conducted for the close evaluation of the effects of Nicorandil on unstable
angina patients.
Introduction
Mortality, myocardial infarction (MI) and controversies in this regard revolve around the
readmission are among the known complications detrimental effect of enzyme rise on the
of unstable angina. Selection of invasive or prognosis of unstable angina patients. MI
conser-vative management strategies depends on associated with percutaneous coronary inter-
the clinical and laboratory conditions of these vention (PCI) is defined as the increase of
patients. Therapeutic agents such as aspirin, biomarkers above 399th percentile upper the
heparin, beta-blockers, and statins are the reference limit.
cornerstone of medical treatment for unstable Recurrent episodes of reversible ischemia
angina patients, while invasive strategies are increase cardiac resistance against ischemia. This
commonly considered for high-risk patients. ischemic preconditioning, which is mediated by
Despite the advances in interventional potassium channels, is a physiological protective
procedures, coronary interventions are still mechanism, Nicorandil is a potassium channel
associated with various complications, such as MI activator, which is considered an effective agent in
(1-3). Furthermore, asymptomatic elevation of the treatment of angina pectoris and
cardiac enzyme levels after coronary inter- hypertension. Lack of drug tolerance has been
ventions is another prominent complication, and proposed as a unique feature of Nicorandil.
*Corresponding author: Atooshe Rohani, Cardiovascular Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran. Tel: 00985138012867; Email: rohania@mums.ac.ir
2016 mums.ac.ir All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
Falsoleiman H et al. Nicorandil on the Clinical and Laboratory Outcomes of Unstable Angina Patients