***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 
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    ***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 A major limitation of the rotational atherectomy ( RA ) procedure is the occurrence of the no-reflow/slow flow phenomenon and the optimal strategy is still evolving . Recent clinical studies have demonstrated the beneficial effects of nicor and il , an adenosine triphosphate (ATP)-sensitive potassium channel opener , on no-reflow in patients with acute myocardial infa rct ion . The purpose of this study was to evaluate the effect of nicor and il  on no-reflow/slow flow phenomenon during RA procedures . Sixty-one patients who underwent RA of complex coronary lesions were r and omly divided into 2 groups : ( i ) nicor and il cocktail ( n=24 patients , 37 lesions ) and ( ii ) verapamil cocktail ( n=37 patients , 63 lesions ) . In each group , the drug cocktail mixed with pressurized saline was infused through the 4Fr Teflon sheath of the rotablator system during the RA procedure . In the nicor and il group , the drug cocktail consisted of 24 mg of nicor and il , 5 mg of nitroglycerin , and 10,000 U of heparin . In the verapamil group , the drug cocktail consisted of 10 mg of verapamil , 5 mg of nitroglycerin , and 10,000 U of heparin . Baseline and procedure characteristics did not differ between the 2 groups . RA was performed successfully , and death , Q-wave myocardial infa rct ion , or emergency coronary artery bypass surgery did not occur in any patients . The no-reflow/slow flow phenomenon was observed in 11/63 ( 17.4 % ) lesions of the verapamil group , but in only 1/37 ( 2.7 % ) lesions of the nicor and il group ( p=0.03 ) . No untoward complications were observed during nicor and il infusion . These data indicate that the intracoronary continuous infusion of nicor and il during RA procedures is easy and safe , and prevents no-reflow/slow flow phenomenon more effectively than infusion of verapamil BACKGROUND The objectives of this study were to evaluate the incidence of no-reflow as independent predictor of adverse events and to assess whether baseline pre-procedural treatment options may affect clinical outcomes . METHODS Data were derived from the ISACS-TC registry ( NCT01218776 ) from October 2010 to January 2015 . No-reflow was defined as post-PCI TIMI flow grade s 0 - 1 , in the absence of post-procedural significant ( ≥25 % ) residual stenosis , abrupt vessel closure , dissection , perforation , thrombus of the original target lesion , or epicardial spasm . The outcome measure was in-hospital mortality . RESULTS No-reflow was identified in 128 of 5997 patients who have undergone PCI ( 2.1 % ) . On multivariate analysis , patients with no-reflow were more likely to be older ( OR : 1.20 , 95 % CI : 1.01 - 1.44 ) , to have a history of hypercholesterolemia ( OR : 1.95 , 95 % CI : 1.31 - 2.91 ) and to be admitted with a diagnosis of STEMI ( OR : 2.96 , 95 % CI : 1.85 - 4.72 ) . Angiographic characteristics associated with no-reflow phenomenon were : stenosis ≥50 % of the right coronary artery , presence of multivessel disease and pre-procedural TIMI blood flow grade s 0 - 1 . No-reflow was highly predictive of in-hospital mortality ( 17.2 % vs. 4.2 % ; adjusted OR : 4.60 , 95 % CI : 2.61 - 8.09 ) . Administration of pre-procedural unfractioned heparin or 600 mg clopidogrel loading dose was associated with less incidence of no-reflow ( OR : 0.65 , 95 % CI : 0.43 - 0.99 and 0.61 , 95 % CI : 0.37 - 1.00 , respectively ) . Aspirin , enoxaparin , and 300 mg clopidogrel loading dose , did not significantly impact the occurrence of the no-reflow . CONCLUSIONS We found that pre-procedural administration of 600 mg loading dose of clopidogrel and /or unfractioned heparin is associated with reduced incidence of no-reflow OBJECTIVE Stress hyperglycemia increases the risk of mortality and poor outcomes in patients with acute myocardial infa rct ion ( AMI ) . We aim ed to assess effects of intravenous nicor and il administered before reperfusion on AMI patients with stress hyperglycemia . RESEARCH DESIGN AND METHODS This study consisted of 158 consecutive first AMI patients with stress hyperglycemia who underwent percutaneous coronary intervention ( PCI ) within 24 h from the onset . They were r and omly assigned to receive 12 mg of nicor and il ( n = 81 ) or a placebo ( n = 77 ) intravenously just before reperfusion . Stress hyperglycemia was defined as a blood glucose level > or = 10 mmol/l ( 180 mg/dl ) . We examined various aspects of epicardial flow and microvascular function as immediate data and major adverse cardiac events ( MACEs ) ( coronary heart disease death or unplanned readmission due to congestive heart failure ) as late-phase data . RESULTS The incidence of slow flow after PCI was lower in the nicor and il group ( 13.6 vs. 27.3 % , P < 0.04 ) . ST segment resolution > 50 % was observed in 70.4 and 53.2 % on nicor and il and placebo , respectively ( P < 0.03 ) . Patients treated with nicor and il had a lower peak creatine kinase level ( 3,137 + /- 2,577 vs. 4,333 + /- 3,608 , P < 0.02 ) . Upon Kaplan-Meier analysis , 5 years ' freedom from MACEs was 86.4 % in the nicor and il group and 74.0 % in the placebo ( P < 0.05 ) . CONCLUSIONS Adjunctive therapy with administration of intravenous nicor and il before reperfusion on AMI patients with stress hyperglycemia significantly improves epicardial flow and prevents the occurrence of severe microvascular reperfusion injury , result ing in better outcomes in these patients Nicor and il , an adenosine triphosphate – sensitive potassium channel opener , reduces plasma norepinephrine concentration in patients with ischemic heart disease . However , long-term effects on cardiac sympathetic nerve activity ( CSNA ) as evaluated by 123I-metaiodobenzylguanidine ( MIBG ) scintigraphy have not been determined for patients with acute myocardial infa rct ion ( AMI ) . Methods : We studied 40 patients with their first AMI who were treated with intravenous nicor and il before and after primary coronary angioplasty .  After suspension of the initial intravenous nicor and il treatment , 20 patients were r and omized to receive oral nicor and il ( 15 mg/d ) ( group A ) and the other 20 patients received a placebo ( group B ) . All patients were also treated with an angiotensin-converting enzyme ( ACE ) inhibitor or β-blockers .  The delayed heart-to-mediastinum count ratio ( H/M ratio ) , delayed total defect score ( TDS ) , and washout rate ( WR ) were determined from 123I-MIBG scintigraphy 3 wk and 6 mo after angioplasty . The left ventricular ( LV ) end-diastolic volume ( EDV ) , LV end-systolic volume ( ESV ) , and LV ejection fraction ( EF ) were determined by contrast left ventriculography , whereas plasma procollagen type III amino-terminal peptide ( PIIINP ) concentrations were also measured at the same time points . Results : Three weeks after angioplasty , TDS , H/M ratios , WR , LVEDV , LVESV , and LVEF were similar in both groups . After 6 mo , all of these parameters had improved in both groups . However , the extent of change in TDS was −9 ± 6 in group A and −5 ± 6 in group B ( P < 0.05 ) , whereas that in the H/M ratio was 0.15 ± 0.13 and 0.07 ± 0.11 ( P < 0.05 ) and that in the WR was −12 % ± 8 % and −5 % ± 11 % ( P < 0.05 ) . The extent of change in LVEDV , LVESV , and LVEF in group A tended to exceed that in group B , but these changes were not statistically significant . We found significant correlations between the percent change in PIIINP and that of TDS from baseline to 6 mo in group A ( r = 0.456 , P < 0.05 ) . Conclusion : Long-term nicor and il therapy can be more beneficial for CSNA and LV remodeling than short-term therapy in patients with AMI 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 Intravenous nicor and il infusion 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 ( MI ) . However , there is limited information on the use of intracoronary nicor and il . METHODS AND RESULTS In the present study , 73 patients with acute ST segment elevation MI undergoing PCI were r and omly assigned to the Nicor and il Group ( n=37 ) or the Control Group ( n=36 ) . The composite endpoints were the incidences of ventricular arrhythmia , no-reflow and slow flow . A significant difference in the composite endpoint was observed in the Nicor and il Group when compared with the Control Group ( p=0.037 ) . The occurrence of post Thrombolysis In Myocardial Infa rct ion ( TIMI ) grade 3 was significantly higher in the Nicor and il Group ( p=0.019 ) . Major adverse cardiac events during hospitalization and within 30 days of treatment were similar between the 2 groups . CONCLUSION Administration of intracor 
    Output:
    
Conclusions Nicor and il  can improve coronary microcirculation and left ventricular function of patients with AMI after PCI .
Interestingly , female patients may benefit more from nicor and il than male patients in improving heart function