European Heart Journal Advance Access originally published online on March 10, 2009
European Heart Journal 2009 30(7):750-751; doi:10.1093/eurheartj/ehp065
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org
Pursuing the goal to improve downstream myocardial tissue perfusion
Department of Cardiology, Ferrarotto Hospital, University of Catania, 95124 Catania, Italy
* Corresponding author. Tel: +39 0957436201, Fax: +39 095362429, Email: tambucor@unict.it
This editorial refers to Intravenous administration of nicorandil immediately before percutaneous coronary intervention can prevent slow coronary flow phenomenon
, by Y. Kawai et al., on page 765
| The first 10% of the full text of this article appears below. |
The coronary slow flow phenomenon is an angiographic finding characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Extensively studied both in the experimental and clinical setting, it was clearly associated with unfavourable clinical outcome and prognosis.1,2 Several hypotheses, including embolization of platelet-rich thrombi or atherosclerotic plaque debris that can sludge the distal vessel, and release of vasoconstrictive substances causing intense vasospasm of the distal microcirculation, were advocated to justify this event in the context of percutaneous coronary intervention.
If the principal mechanism of the slow flow phenomenon is vasoconstriction, this would explain the favourable response seen with intracoronary administration of calcium antagonists such as verapamil, or vasodilators such as nitroprusside, papaverine, and adenosine.
Nicorandil, a nicotinamide ester, is a vasodilator agent approved
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EHJ 2009 30: 765-772.[Abstract] [Full Text]