Cardiovascular Intervention and Therapeutics

, Volume 29, Issue 1, pp 24–30

Utility of nicorandil for the measurement of coronary fractional flow reserve

  • Maki Oi
  • Mamoru Toyofuku
  • Yukiko Matsumura
  • Yasuyo Motohashi
  • Kousuke Takahashi
  • Yuichi Kawase
  • Euihong Ko
  • Mariko Tanaka
  • Masahiko Kitada
  • Yosuke Yuzuki
  • Takashi Tamura
  • Nobuhiro Tanaka
  • Takeshi Kimura
Original Article

Abstract

Nicorandil, an adenosine triphosphate (ATP)-sensitive potassium channel opener, has been used as an anti-angina drug that causes coronary vasodilation of both epicardial and resistance vessels. We assessed the hyperaemic efficacy of nicorandil for the measurement of coronary fractional flow reserve (FFR). In this prospective, single-centre study, we enrolled 20 consecutive patients (20 lesions) with intermediate coronary artery stenosis. Hyperaemic efficacy of intracoronary bolus injection of nicorandil (2 mg) was compared with that of continuous intravenous infusion of adenosine triphosphate (ATP, 150 μg/kg/min). The intra-patient difference of FFR value between the two hyperaemic stimuli was evaluated using a non-inferiority design with the margin of 0.03. Among study patients, no serious event occurred with administration of either stimulus. A strong and linear correlation of FFR with ATP and nicorandil was observed (r2 = 0.98, P < 0.0001). The intra-patient difference of the FFR between nicorandil and ATP was 0.003 (95 % confidence interval −0.004 to 0.011), and the probability for the non-inferiority margin of 0.03 was <0.0001. In conclusion, bolus intracoronary injection of nicorandil was non-inferior to continuous intravenous injection of ATP in achieving maximal hyperaemia. Nicorandil could be considered as an alternative option for achieving maximal coronary and myocardial hyperaemia for the assessment of FFR.

Keywords

Coronary disease FFR Hyperaemia 

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2013

Authors and Affiliations

  • Maki Oi
    • 1
  • Mamoru Toyofuku
    • 1
  • Yukiko Matsumura
    • 1
  • Yasuyo Motohashi
    • 1
  • Kousuke Takahashi
    • 1
  • Yuichi Kawase
    • 1
  • Euihong Ko
    • 1
  • Mariko Tanaka
    • 1
  • Masahiko Kitada
    • 1
  • Yosuke Yuzuki
    • 1
  • Takashi Tamura
    • 1
  • Nobuhiro Tanaka
    • 2
  • Takeshi Kimura
    • 3
  1. 1.Japanese Red Cross Society Wakayama Medical CenterWakayamaJapan
  2. 2.Tokyo Medical University HospitalTokyoJapan
  3. 3.Kyoto UniversityKyotoJapan

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