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

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          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.

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          Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study

          Moien AB Khan, Muhammad Jawad Hashim, Halla Mustafa … (2020)
          Background Ischemic heart disease (IHD) is a leading cause of death worldwide. Also referred to as coronary artery disease (CAD) and atherosclerotic cardiovascular disease (ACD), it manifests clinically as myocardial infarction and ischemic cardiomyopathy. This study aims to evaluate the epidemiological trends of IHD globally. Methods The most up-to-date epidemiological data from the Global Burden of Disease (GBD) dataset were analyzed. GBD collates data from a large number of sources, including research studies, hospital registries, and government reports. This dataset includes annual figures from 1990 to 2017 for IHD in all countries and regions. We analyzed the incidence, prevalence, and disability-adjusted life years (DALY) for IHD. Forecasting for the next two decades was conducted using the Statistical Package for the Social Sciences (SPSS) Time Series Modeler (IBM Corp., Armonk, NY). Results Our study estimated that globally, IHD affects around 126 million individuals (1,655 per 100,000), which is approximately 1.72% of the world’s population. Nine million deaths were caused by IHD globally. Men were more commonly affected than women, and incidence typically started in the fourth decade and increased with age. The global prevalence of IHD is rising. We estimated that the current prevalence rate of 1,655 per 100,000 population is expected to exceed 1,845 by the year 2030. Eastern European countries are sustaining the highest prevalence. Age-standardized rates, which remove the effect of population changes over time, have decreased in many regions. Conclusions IHD is the number one cause of death, disability, and human suffering globally. Age-adjusted rates show a promising decrease. However, health systems have to manage an increasing number of cases due to population aging.
          Article 0 comments Cited 240 times – based on 0 reviews     Review now
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            Updates on Acute Coronary Syndrome: A Review.

            Alon Eisen, Robert Giugliano, Eugene Braunwald (2016)
            Acute coronary syndrome (ACS), the acute manifestation of ischemic heart disease, remains a major cause of morbidity and mortality worldwide and is responsible for more than 1 million hospital admissions in the United States annually. Considerable research is being conducted in the field. This review provides a contemporary overview of key new findings on the pathophysiology, diagnosis, treatment, and prognosis of ACS.
            Article 0 comments Cited 69 times – based on 0 reviews     Review now
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              Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: prospective cohort study.

              C Bucciarelli-Ducci, P Tejedor-Real, A. Kansal … (2008)
              Ejection fraction (EF) and end-systolic volume index (ESVI) are established predictors of outcomes following ST-segment elevation myocardial infarction (STEMI). We sought to assess the relative impact of infarct size, EF and ESVI on clinical outcomes and left ventricular (LV) remodelling. Prospective cohort study. Academic hospital in Chicago, USA. 122 patients with STEMI following acute percutaneous reperfusion. Death, recurrent myocardial infarction (MI) and heart failure. Cardiac magnetic resonance imaging was obtained within 1 week following STEMI in 122 subjects. ESVI, EF and infarct size were tested for the association with outcomes over 2 years in 113 subjects, and a repeat study was obtained 4 months later to assess LV remodelling in 91 subjects. Acute infarct size correlated linearly with the initial ESVI (r = 0.69, p<0.001), end-diastolic volume index (EDVI) (r = 0.42, p<0.001) and EF (r = -0.75, p<0.001). All were independently associated with outcomes (one death, one recurrent MI and 16 heart failure admissions). However, infarct size was the only significant predictor of adverse outcomes (p<0.05) by multivariate analysis. The smallest infarct size tertile had an increased EF (49% (SD 8%) to 53% (6%); p = 0.002) and unchanged EDVI (p = 0.7). In contrast, subjects with the largest infarct tertile also had improved EF (32% (9%) to 36% (11%); p = 0.002) at the expense of a dramatic increase in EDVI (86 (19) to 95 (21) ml/m(2); p = 0.005). Infarct size, EF and ESVI can predict the development of future cardiac events. Acute infarct size, which is independent of LV stunning and loading, directly relates to LV remodelling and is a stronger predictor of future events than measures of LV systolic performance.
              Article 0 comments Cited 43 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pak J Med Sci
                Journal ID (iso-abbrev): Pak J Med Sci
                Title: Pakistan Journal of Medical Sciences
                Publisher: Professional Medical Publications (Pakistan )
                ISSN (Print): 1682-024X
                ISSN (Electronic): 1681-715X
                Publication date (Print): Jan-Feb 2023
                Volume: 39
                Issue: 1
                Pages: 177-181
                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
                Author notes
                Correspondence: Dr. Maria Ilyas, MBBS. Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan. Email: mariamaaz243@ 123456gmail.com
                Article
                Publisher ID: PJMS-39-177
                DOI: 10.12669/pjms.39.1.6034
                PMC ID: 9842976
                PubMed ID: 36694786
                SO-VID: d4c16a48-c466-4ae1-b53e-5fde851f07bf
                Copyright © Copyright: © Pakistan Journal of Medical Sciences
                License:

                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.

                History
                Date received : 13 January 2022
                Date revision received : 05 October 2022
                Date revision received : 18 October 2022
                Date accepted : 26 October 2022
                Categories
                Subject: Original Article

                Keywords: nicorandil,percutaneous coronary intervention,myocardial reperfusion injury,cardio protective agents
                Data availability:
                Keywords: nicorandil, percutaneous coronary intervention, myocardial reperfusion injury, cardio protective agents

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