***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Nicor and il in conjunction with percutaneous coronary intervention ( PCI ) has been reported to reduce reperfusion injury events and improve cardiac function in patients with acute myocardial infa rct ion ( AMI ) . This multicenter study was undertaken to determine the effectiveness and optimal administration of nicor and il in AMI patients . METHODS AND RESULTS Ninety-two patients with first AMI were r and omly assigned to 1 of 3 groups : intracoronary administration of nicor and il ( Group A ) , combined intravenous and intracoronary administration of nicor and il ( Group B ) , and no nicor and il administration ( Group C ) . The primary endpoint was a composite of the incidence of reperfusion-induced arrhythmia , chest pain , and no-reflow/slow-reflow . The secondary endpoint was the combined rate of improvement in the Thrombolysis in Myocardial Infa rct ion frame count ( cTFC ) and ST resolution ( STR ) . A significant difference was observed in the primary endpoint for Group B as compared with Group C ( p<0.05 ) . In the meantime , a significant improvement was shown in the secondary endpoint for Group B compared with Group C ( p=0.04 and 0.006 for cTFC and STR , respectively ) . CONCLUSIONS Combined intravenous and intracoronary administration of nicor and il reduces reperfusion injury during PCI and improves the cTFC and STR in AMI , and appears to be preferable to intracoronary administration alone Background It has been reported that nicor and il restores blood flow to reperfused myocardium in patients with acute myocardial infa rct ion . However , whether nicor and il might decrease infa rct size remains unclear . The aim of this study was to assess the effect of nicor and il on infa rct size with thallium-201/ ® -methyl-p-iodophenyl pentadecanoic acid ( BMI PP ) dual-isotope single photon emission computed tomography . Methods A total of 62 patients were r and omly assigned to receive intravenous nicor and il ( 4 mg in 5 minutes at admission , immediately followed by 6mg/hr over a 24-hour period ) or placebo . All patients were divided into 4 groups : Group N-a , 16 patients with preexisting angina treated with nicor and il ; N-b , 15 patients without preexisting angina treated with nicor and il ; Ca , 14 patients with preexisting angina given placebo ; C-b , 17 patients without preexisting angina given placebo . Tl-201/ BMI PP imaging was performed in the 62 patients within 7 days after admission . Dual-isotope single photon emission computed tomographic images were quantified by severity index with a polar map . Results The BMI PP severity index was similar among the 4 groups . Only the thallium severity index in the N-a group was significantly less ( P < .05 ) . The ratio of the thallium severity index to that of BMI PP in the N-a group was significantly decreased compared with those of the other groups . Conclusion Nicor and il has a protective effect in patients with acute myocardial infa rct ion and preexisting angina treated with primary balloon angioplasty Background —Although 90-minute TIMI flow grade s ( TFGs ) , corrected TIMI frame counts ( CTFCs ) , and TIMI myocardial perfusion grade s ( TMPGs ) have been associated with 30-day outcomes , we hypothesized that these indices would be related to long-term outcomes after thrombolytic administration . Methods and Results —As a sub study of the TIMI 10B trial ( tissue plasminogen activator versus tenecteplase ) , 49 centers carried out 2-year follow-up . TIMI grade 2/3 flow ( Cox hazard ratio [ HR ] 0.41 , P = 0.001 ) , reduced CTFCs ( faster flow , P = 0.02 ) , and an open microvasculature ( TMPG 2/3 ) ( HR 0.51 , P = 0.038 ) were all associated with improved 2-year survival .  Rescue percutaneous coronary intervention ( PCI ) of closed arteries ( TFG 0/1 ) at 90 minutes was associated with reduced mortality ( P = 0.03 ) , and mortality trended lower with adjunctive PCI of open ( TFG 2/3 ) arteries ( P = 0.11 ) . In a multivariate model correcting for previously identified correlates of mortality ( age , sex , pulse , left anterior descending coronary artery infa rct ion , and any PCI during initial hospitalization ) , patency ( TFG 2/3 ) ( HR 0.32 , P < 0.001 ) , CTFC ( P = 0.01 ) , and TMPG 2/3 remained associated with reduced mortality ( HR 0.46 , P = 0.02 ) . Conclusions —Both improved epicardial flow ( TFG 2/3 and low CTFCs ) and tissue-level perfusion ( TMPG 2/3 ) at 90 minutes after thrombolytic administration are independently associated with improved 2-year survival , suggesting complementary mechanisms of improved long-term survival . Although rescue PCI reduced long-term mortality , improved microvascular perfusion ( TMPG 2/3 ) before PCI was also related to improved mortality independently of epicardial blood flow and the performance of rescue or adjunctive PCI . Further prospect i ve trials are warranted to re-examine the benefit of early PCI with thrombolysis The efficacy and safety of high-dose nicor and il therapy in acute myocardial infa rct ion ( AMI ) have not yet been clarified . This is a prospect i ve study including 30 patients who received nicor and il at 0.06 mg/kg/h [ st and ard dose nicor and il ( SDN ) group ] and 32 patients who received a bolus injection of nicor and il 0.2 mg/kg followed by a continuous infusion at 0.2 mg/kg/h [ high-dose nicor and il ( HDN ) group ] . The benefits and adverse events were assessed during acute phase and 12-month follow-up period . There were no significant differences between the groups in blood pressure , heart rate or urine volume 2 , 6 and 24 h after drug administration , although blood pressure decreased during acute phase . The percentages of patients who required dose reduction or discontinuation of nicor and il were 34.4 and 16.7 % in HDN and SDN groups , respectively ( p = 0.11 ) . In HDN group , subgroup analysis revealed that the TIMI frame count ( TFC ) was significantly lower in patients in whom the treatment was started within 12 h compared to those more than 12 h ( 17.0 vs. 21.0 , p = 0.017 ) and in patients with baseline WBC elevation compared to those without it ( 16.5 vs. 22.0 , p = 0.029 ) . A TFC of > 20 was significantly associated with being in HDN group [ odds ratio ( OR ) 0.27 ; 95 % confidence interval , CI 0.07–0.89 ] , onset-to-balloon time ( OR 1.06 ; 95 % CI 1.01–1.16 ) , and ∑creatine kinase ( OR 7.27 ; 95 % CI 1.40–57.83 ) . There were no significant differences in incidences of cardiovascular death , rehospitalization , and target lesion revascularization between the groups . HDN therapy may improve coronary microcirculation in patients with AMI 17,187 patients entering 417 hospitals up to 24 hours ( median 5 hours ) after the onset of suspected acute myocardial infa rct ion were r and omised , with placebo control , between : ( i ) a 1-hour intravenous infusion of 1.5 MU of streptokinase ; ( ii ) one month of 160 mg/day enteric-coated aspirin ; ( iii ) both active treatments ; or ( iv ) neither . Streptokinase alone and aspirin alone each produced a highly significant reduction in 5-week vascular mortality : 791/8592 ( 9.2 % ) among patients allocated streptokinase infusion vs 1029/8595 ( 12.0 % ) among those allocated placebo infusion ( odds reduction : 25 % SD 4 ; 2p less than 0.00001 ) ; 804/8587 ( 9.4 % ) vascular deaths among patients allocated aspirin tablets vs 1016/8600 ( 11.8 % ) among those allocated placebo tablets ( odds reduction : 23 % SD 4 ; 2p less than 0.00001 ) . The combination of streptokinase and aspirin was significantly ( 2p less than 0.0001 ) better than either agent alone . Their separate effects on vascular deaths appeared to be additive : 343/4292 ( 8.0 % ) among patients allocated both active agents vs 568/4300 ( 13.2 % ) among those allocated neither ( odds reduction : 42 % SD 5 ; 95 % confidence limits 34 - 50 % ) . There was evidence of benefit from each agent even for patients treated late after pain onset ( odds reductions at 0 - 4 , 5 - 12 , and 13 - 24 hours : 35 % SD 6 , 16 % SD 7 , and 21 % SD 12 for streptokinase alone ; 25 % SD 7 , 21 % SD 7 , and 21 % SD 12 for aspirin alone ; and 53 % SD 8 , 32 % SD 9 , and 38 % SD 15 for the combination of streptokinase and aspirin ) . Streptokinase was associated with an excess of bleeds requiring transfusion ( 0.5 % vs 0.2 % ) and of confirmed cerebral haemorrhage ( 0.1 % vs 0.0 % ) , but with fewer other strokes ( 0.6 % vs 0.8 % ) . These " other " strokes may have included a few undiagnosed cerebral haemorrhages , but still there was no increase in total strokes ( 0.7 % streptokinase vs 0.8 % placebo infusion ) . Aspirin significantly reduced non-fatal reinfa rct ion ( 1.0 % vs 2.0 % ) and non-fatal stroke ( 0.3 % vs 0.6 % ) , and was not associated with any significant increase in cerebral haemorrhage or in bleeds requiring transfusion . An excess of non-fatal reinfa rct ion was reported when streptokinase was used alone , but this appeared to be entirely avoided by the addition of aspirin . Those allocated the combination of streptokinase and aspirin had significantly fewer reinfa rct ions ( 1.8 % vs 2.9 % ) , strokes ( 0.6 % vs 1.1 % ) , and deaths ( 8.0 % vs 13.2 % ) than those allocated neither . The differences in vascular and in all-cause mortality produced by streptokinase and by aspirin remain highly significant ( 2p less than 0.001 for each ) after the median of 15 months of follow-up thus far available Background —Intravenous nicor and il , a hybrid compound of ATP-sensitive potassium channel opener and nitric oxide donor , has been reported to ameliorate early functional and clinical problems in patients with acute myocardial infa rct ion . However , its effects on the late phase remain unclear . Methods and Results —This follow-up study to 5 years of a r and omized , double-blinded trial was conducted among 368 patients with first ST-segment – elevation myocardial infa rct ion undergoing percutaneous coronary intervention ( PCI ) . They were r and omly assigned to receive 12 mg of nicor and il or a placebo intravenously just before reperfusion . We analyzed incidence of cardiovascular death or rehospitalization for congestive heart failure after PCI as well as various aspects of epicardial flow and microvascular function . Mean follow-up was 2.4 years ( SD , 1.4 ) . A total of 12 ( 6.5 % ) patients receiving nicor and il and 30 ( 16.4 % ) receiving placebo  had cardiovascular death or hospital admission for congestive heart failure ( hazard ratio , 0.39 ; 95 % CI , 0.20 to 0.76 ; P=0.0058 ) . Postprocedural TIMI 3 flow was obtained in 89.7 % of the nicor and il group and in 81.4 % of the placebo ( hazard ratio , 1.99 ; 95 % CI , 1.09 to 3.65 ; P=0.025 ) . Corrected TIMI frame count was furthermore lower in the nicor and il group ( 21.0±9.1 versus 25.1±14.1 ; P=0.0009 ) . ST-segment resolution > 50 % was observed in 79.5 % and 61.2 % of the nicor and il and placebo groups , respectively ( hazard ratio , 2.45 ; 95 % CI , 1.54 to 3.90 ; P=0.0002 ) . Conclusions —The addition of intravenous nicor and il to PCI leads to beneficial clinical outcomes and prevents cardiovascular events of long duration and 
    Output:
    
CONCLUSIONS Nicor and il prior to reperfusion is associated with improvement of coronary reflow as well as suppression of ventricular arrhythmia , and further improves left ventricular function in patients who suffered from AMI and underwent primary PCI .