High Index of Microcirculatory Resistance Level After Successful Primary Percutaneous Coronary Intervention Can Be Improved by Intracoronary Administration of Nicorandil
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概要
- 論文の詳細を見る
Background: Although microvascular dysfunction following percutaneous coronary intervention (PCI) can be evaluated with the index of microcirculatory resistance (IMR), no method of treatment has been established. We hypothesized that intracoronary administration of nicorandil can improve IMR after successful primary PCI in patients with ST-segment elevation myocardial infarction (STEMI). Methods and Results: In 40 patients with first STEMI after successful primary PCI, IMR was measured using PressureWireTM Certus (St. Jude Medical, MN, USA). In 20 of the patients (Group N), IMR was measured at baseline and after intracoronary nicorandil (2 mg/10 ml). In the other 20 patients (Control), IMR was measured at baseline, after intracoronary saline (10 ml) and after intracoronary nicorandil (2 mg/10 ml). In Group N, IMR significantly decreased after intracoronary nicorandil (median IMR, 27.7-18.7 U, P<0.0001). In the Control group, IMR did not change after saline administration (median IMR, 24.3-23.8 U, P=0.8193), but was significantly decreased after intracoronary nicorandil (median IMR, 23.8-14.9 U, P<0.0001). Next, all 40 patients were divided into subgroups by tertile of baseline IMR. In those with intermediate to high IMR (baseline IMR ≥21), intracoronary nicorandil significantly decreased IMR, although it did not change IMR in those with low IMR (baseline IMR <21). Conclusions: High IMR levels in patients with STEMI after successful primary PCI can be improved by intracoronary administration of nicorandil.
- 2010-04-25
著者
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Nanto Shinsuke
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Yamashita Shizuya
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Masuda Daisaku
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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Yamashita Shizuya
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Masuda Daisaku
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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ITO Noritoshi
Critical & Cardiovascular Care Unit
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DOI Yasuji
Critical & Cardiovascular Care Unit
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SAWANO Hirotaka
Critical & Cardiovascular Care Unit
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OKADA Ken-ichiro
Critical & Cardiovascular Care Unit
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KAIBE Shoji
Critical & Cardiovascular Care Unit
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HAYASHI Yasuyuki
Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
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KAI Tatsuro
Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
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HAYASHI Toru
Critical & Cardiovascular Care Unit
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Nanto Shinsuke
Department Of Advanced Cardiovascular Therapeutics
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Okada Kenichiro
Critical & Cardiovascular Care Unit
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Kai Tatsuro
Senri Critical Care Medical Center Osaka Saiseikai Senri Hospital
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Doi Yasuji
The First Department Of Medicine Osaka University School Of Medicine
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Doi Yasuji
Critical & Cardiovascular Care Unit
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Kaibe Shoji
Critical & Cardiovascular Care Unit
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Hayashi Toru
Critical & Cardiovascular Care Unit
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Ito Noritoshi
Critical & Cardiovascular Care Unit
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Sawano Hirotaka
Critical & Cardiovascular Care Unit
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Hayashi Yasuyuki
Senri Critical Care Medical Center Osaka Saiseikai Senri Hospital
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Yamashita Shizuya
Department Of Cardiovascular Medicine Juntendo University School Of Medicine
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