Three-year clinical outcomes of a fractional flow reserve-guided percutaneous coronary intervention (PCI) strategy: A comparison of nicorandil and ATP

Three-year clinical outcomes of a fractional flow reserve-guided percutaneous coronary intervention (PCI) strategy: A comparison of nicorandil and ATP

Background: Nicorandil is used to induce hyperemia when measuring fractional flow reserve (FFR). However, it is unknown whether the clinical outcome of patients assessed using nicorandil is similar to that of patients assessed using adenosine triphosphatase (ATP). We aimed to compare the clinical ou...

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Main Authors: Yuki Numajiri, Daisuke Wada, Yuki Ishii, Yuka Tanizaki, Yosuke Takei, Hiromoto Sone, Kazuma Tashiro, Takuya Mizukami, Tokutada Sato, Takaaki Matsuyama, Hiroshi Suzuki, Hiroyoshi Mori
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:International Journal of Cardiology: Heart & Vasculature
Subjects:
Nicorandil
FFR
Hyperemia
Online Access:http://www.sciencedirect.com/science/article/pii/S2352906725001113
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Summary:Background: Nicorandil is used to induce hyperemia when measuring fractional flow reserve (FFR). However, it is unknown whether the clinical outcome of patients assessed using nicorandil is similar to that of patients assessed using adenosine triphosphatase (ATP). We aimed to compare the clinical outcomes of nicorandil and ATP in the PCI and deferred groups. Methods: This retrospective study examined 492 patients with chronic coronary syndrome who underwent FFR assessment between February 2016 and December 2021. The patients received either nicorandil or ATP to induce hyperemia. The primary endpoints were all-cause death, myocardial infarction, and urgent revascularization. These clinical outcomes were followed up for three years and compared between the groups. Results: In the PCI group (161 patients), primary endpoint events occurred in 9 % of the nicorandil group and 11 % of the ATP group (Adjusted HR 1.10, 95 % CI 0.35–3.40, P = 0.87). In the deferred group (331 patients), primary events occurred in 7 % of the patients in both groups (Adjusted HR 1.39, 95 % CI 0.55–3.49, P = 0.49). Kaplan-Meier curves showed no significant differences in event rates between nicorandil and ATP in either group. Conclusions: In the evaluation of FFR, nicorandil is a safe and simple alternative that shows similar clinical outcomes to ATP.
ISSN:2352-9067

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