Cardio protective effect of nicorandil in reperfusion injury among patients undergoing primary percutaneous coronary intervention

Maria Ilyas; Mudassar Noor; Hamid Sharif Khan; Sauleha Haroon; Kulsoom Farhat; Shabana Ali

doi:10.12669/pjms.39.1.6034

Cardio protective effect of nicorandil in reperfusion injury among patients undergoing primary percutaneous coronary intervention

Pak J Med Sci. 2023 Jan-Feb;39(1):177-181. doi: 10.12669/pjms.39.1.6034.

Authors

Maria Ilyas¹, Mudassar Noor², Hamid Sharif Khan³, Sauleha Haroon⁴, Kulsoom Farhat⁵, Shabana Ali⁶

Affiliations

¹ Dr. Maria Ilyas, MBBS., Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.
² Dr. Mudassar Noor, Associate Professor of Pharmacology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.
³ Dr. Hamid Sharif Khan, Assistant Professor of Cardiology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan.
⁴ Dr. Sauleha Haroon, Senior Registrar of Cardiology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan.
⁵ Dr. Kulsoom Farhat, Professor of Pharmacology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.
⁶ Dr. Shabana Ali, Assistant Professor of Pharmacology, Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.

Abstract

Objectives: To evaluate the effect of nicorandil in prevention of reperfusion injury during primary percutaneous coronary intervention by thrombolysis in myocardial infarction flow grade scoring.

Methods: A total of 140 patients from Rawalpindi Institute of Cardiology were enrolled in this study conducted from 7^th September to 10^th of October 2021. These participants were allocated into two major groups. Control group received conventional acute coronary syndrome protocol regimen only whereas experimental group was given nicorandil along with conventional acute coronary syndrome protocol. During primary percutaneous coronary intervention, thrombolysis in myocardial infarction flow grade scoring was analyzed and compared.

Results: Majority of participants in nicorandil group achieved thrombolysis in myocardial infarction Grade-3 scoring which indicated reduced rate of no reflow phenomenon as compared to control group. A statistically significant difference was noted in score of both groups (p value = 0.001) signifying prophylactic use of nicorandil before primary percutaneous coronary intervention along with conventional acute coronary syndrome protocol is superior to only conventional acute coronary syndrome protocol regimen to cases in the control group.

Conclusion: Use of nicorandil in ST elevated myocardial infarction patients before primary percutaneous coronary intervention prevents reperfusion injury thus decreasing the risk of post percutaneous coronary intervention complications and reducing mortality rate in cardiac patients suggesting its significant cardio protective role.

Keywords: Cardio protective agents; Nicorandil; Percutaneous coronary intervention; myocardial reperfusion injury.