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      The Efficacy and Safety of Nicorandil for Periprocedural Myocardial Injury in Patients Undergoing PCI: A Meta-Analysis

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      Journal of Interventional Cardiology
      Hindawi

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          Abstract

          Purpose

          To evaluate the efficacy and safety of nicorandil for periprocedural myocardial injury in patients undergoing PCI through meta-analysis of randomized controlled trials.

          Methods

          We analyzed the clinical data of patients including the incidence of periprocedural myocardial injury (PMI) and major adverse cardiovascular events (MACE) from selected articles. RCTs were retrieved from medical literature databases. RR and 95% confidence intervals (CI) were calculated to compare the endpoints.

          Results

          In total, 15 articles (16 trial comparisons) were retrieved which contained 2221 patients. In general, 1130 patients (50.9%) were randomized to the experimental group, whereas 1091 patients (49.1%) were randomized to the control group. The result showed that nicorandil significantly reduced the incidence of PMI and MACE after PCI compared to the control group.

          Conclusions

          Overall, early use of nicorandil in patients undergoing percutaneous coronary intervention (PCI) was associated with a significant reduction of PMI and MACE.

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          Most cited references40

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          RoB 2: a revised tool for assessing risk of bias in randomised trials

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            Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

            David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
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              Peri-procedural myocardial injury during percutaneous coronary intervention: an important target for cardioprotection.

              Percutaneous coronary intervention (PCI) has become the predominant procedure for coronary revascularization in patients with both stable and unstable coronary artery disease (CAD). Over the past two decades, technical advances in PCI have resulted in a better and safer therapeutic procedure with minimal procedural complications. However, about 30% of patients undergoing elective PCI sustain myocardial injury arising from the procedure itself, the extent of which is significant enough to carry prognostic importance. The peri-procedural injury which accompanies PCI might therefore reduce some of the beneficial effects of coronary revascularization. The availability of more sensitive serum biomarkers of myocardial injury such as creatine phosphokinase MB isoenzyme (CK-MB), Troponin T, and Troponin I has enabled the quantification of previously undetectable myocardial injury. Peri-procedural myocardial injury (PMI) can also be visualized by cardiac magnetic resonance imaging, a technique which allows the detection and quantification of myocardial necrosis following PCI. The identification of CAD patients at greatest risk of sustaining PMI during PCI would allow targeted treatment with novel therapies capable of limiting the extent of PMI or reducing the number of patients experiencing PMI.
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                Author and article information

                Contributors
                Journal
                J Interv Cardiol
                J Interv Cardiol
                JITC
                Journal of Interventional Cardiology
                Hindawi
                0896-4327
                1540-8183
                2020
                6 November 2020
                : 2020
                : 3293587
                Affiliations
                Department of Cardiology, The Second People's Hospital of Nanning, The Third Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
                Author notes

                Academic Editor: Jochen Wöhrle

                Author information
                https://orcid.org/0000-0001-9088-2702
                Article
                10.1155/2020/3293587
                7665917
                6202f289-a319-444f-9001-a9d3da7f5f27
                Copyright © 2020 Yuanxi Lu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 June 2020
                : 1 October 2020
                : 27 October 2020
                Categories
                Research Article

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