Coronary Heart Disease Clinical Trial
Official title:
Effect of Early Administration of Intracoronary Nicorandil Via Thrombus Aspiration Catheter Device During Primary Percutaneous Coronary Intervention for the Patients of Acute ST Segment Elevation Myocardial Infarction
To evaluate whether nicorandil as an adjunctive therapy for acute myocardial infarction (AMI) reduces reperfusion injury.
Reperfusion injury might occur in patients with acute ST segment elevation myocardial
infarction undergoing the primary percutaneous coronary intervention(P-PCI),characterized by
myocardial stunning, reperfusion-induced arrhythmia, microvascular dysfunction and
myocardial cellular apoptosis, etc.
Nicorandil is an antianginal agent with a dual mechanism of action: nitrate and K+ATP
channel opener. The nitrate action causes vasodilation of systemic veins and epicardial
coronary arteries, while the adenosine triphosphate (ATP)-sensitive potassium channel opener
action causes vasodilation of peripheral and coronary resistance arterioles. Nicorandil not
only decreases preload and afterload but also increases coronary blood flow.
The study will compare the effectiveness between nicorandil and placebo of preventing the
reperfusion injury and left ventricle remodeling in patients with acute ST segment elevation
myocardial infarction undergoing the P-PCI.It is intended that before reperfusion injury
,nicorandil which was early used by intracoronary injection could prevent and release the
microcirculatory spasm, release the coronary microvascular endothelial swelling,decrease
embolism of atherosclerotic debris and thrombus formation.So,it could decrease the
phenomenon of no-reflow/slow reflow,reperfusion-induced arrhythmia and worsening of chest
pain.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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