Intravenous Nicorandil in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI: The CLEAN Randomized Clinical Trial.
J Am Coll CardiolAug 12, 2026 (epub)
Clinical ResearchCardiology
Dong Huang, Hongxian Wu, Yuan Lu et al.
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In 30 seconds
The CLEAN trial evaluated the effect of intravenous nicorandil on 12-month clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI. In this multicenter, randomized, double-blind trial involving 1,503 patients, the primary composite outcome occurred in 13.1% of both the nicorandil and placebo groups, indicating no significant difference (rate ratio: 0.869; P = 0.3429).
Key findings
- The primary composite outcome occurred in 13.1% of both nicorandil and placebo groups.
- Cardiovascular death rates were 1.9% in the nicorandil group versus 3.6% in the placebo group.
- Target-vessel revascularization rates were 1.1% for nicorandil compared to 3.0% for placebo.
- Adverse events did not differ significantly between the two groups.
Why it matters
Understanding the efficacy of adjunctive therapies like nicorandil in STEMI patients is crucial for optimizing treatment strategies and improving patient outcomes. This study suggests that nicorandil may not provide significant benefits in this context.