Nicorandil, a potent cardioprotective agent, reduces QT dispersion during coronary angioplasty

Abstract Background Previous studies have found that ST-segment elevation and QT dispersion are smaller in second coronary occlusions than in first occlusions, a trend that suggests ischemic preconditioning. It has not been established whether nicorandil reduces ST-segment elevation and QT dispersion during coronary angioplasty. Methods and Results Thirty patients with stable angina undergoing coronary angioplasty in the proximal left anterior descending artery were randomly assigned to one of two groups, receiving either 5 mg oral nicorandil 3 times daily (n = 15) or placebo (n = 15). In the control patients, the total ST-segment elevation decreased from 14 ± 3 mm during the first inflation to 7 ± 2 mm during the second inflation ( P P = not significant). After the first reperfusion, a significantly smaller increase in QT dispersion was observed in the nicorandil-treated patients than in the control patients (43 ± 15 ms vs 54 ± 15 ms, P P = not significant). Conclusions Nicorandil may precondition the myocardium and may prevent the occurrence of ventricular arrhythmias after coronary reperfusion by suppressing the increase in QT dispersion. (Am Heart J 2001;141:940-3.)