ArticleFrontiers in cardiovascular medicine2026
Intracoronary nicorandil improves coronary microcirculatory function after primary PCI in first-episode STEMI: an angiography-derived evaluation using AMR and QFR.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Microvascular dysfunction remains a major driver of adverse outcomes after ST-segment elevation myocardial infarction (STEMI) despite successful restoration of epicardial patency by primary percutaneous coronary intervention (PCI). Nicorandil has nitrate-like vasodilatory properties and ATP-dependent potassium channel (KATP)-opening properties, effects that may improve reperfusion physiology. However, its effects on wire-free, angiography-derived measures of microvascular function are not well defined. We evaluated whether intracoronary nicorandil administered during primary PCI improves angiography-derived microvascular function assessed by angiographic microcirculatory resistance (AMR) and quantitative flow ratio (QFR). Methods: In this prospective, single-center randomized trial, 63 patients with first-episode STEMI undergoing primary PCI were allocated 1:1 to intracoronary nicorandil (2 mg after guidewire crossing; Results: Baseline characteristics were balanced between groups. Compared with control, intracoronary nicorandil was associated with a higher rate of post-PCI TIMI grade 3 flow (96.9% vs. 74.2%; overall Conclusions: In this pilot randomized study, intracoronary nicorandil administered during primary PCI was associated with improved angiography-derived surrogate indices of microvascular resistance and epicardial physiology without an observed increase in peri-procedural hemodynamic instability or short-term adverse events. These findings should be interpreted as exploratory and warrant confirmation in larger multicenter studies with longer follow-up and outcome-linked validation.
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