Efficacy of nicorandil in preventing contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Efficacy of nicorandil in preventing contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Objective The aim of this multi-center prospective randomized controlled trial is to evaluate the efficacy of nicorandil for the prevention of contrast-induced nephropathy(CIN)after primary percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods Patients with STEMI received primary PCI were enrolled,and they were randomly assigned into nicorandil group and placebo group,receiving intravenous nicorandil or placebo before primary PCI.The endpoint was the incidence of CIN,defined as an absolute increase in serum creatinine(SCr)＞0.5 mg/dl or a relative increase＞25％compared with baseline SCr.The secondary endpoints were major adverse cardiovascular events(MACEs)within a year.Results The final study population included 238 randomized patients,and 226 of them(n=113 for each group)monitored the perioperative renal function,and were included in the primary analysis.Compared with the placebo group,the final TIMI grade in the nicorandil group was significantly better(P=0.001),and the incidence of CIN in nicorandil group was significantly lower(9.7％vs.24.8％,P=0.003).The logistic regression analysis revealed that nicorandil was significantly associated with the decreased risk of CIN(OR 0.379,95％CI 0.16-0.86,P=0.021).Conclusions Nicorandil is an independent protective factor for CIN in STEMI patients undergoing primary PCI.Our study indicated that intravenous nicorandil could prevent CIN in patients with STEMI undergoing primary PCI.
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