Feng C, et al. - In this randomized controlled trial involving acute ST-segment elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI), researchers investigated if nicorandil administration distal to the thrombus in the coronary artery during PCI reduced the incidence of no-reflow phenomenon, reperfusion injury, and adverse events. Six-month cardiovascular mortality or unplanned readmission rate was the primary endpoint (major adverse cardiac events, MACEs) and the secondary endpoints included thrombolysis in myocardial infarction (TIMI) grade, TIMI myocardial perfusion grade, resolution of ST-segment elevation (defined as >50% decrease in ST elevation), and ventricular arrhythmias. Findings suggested that an attenuated incidence of reperfusion injury and improved short-term clinical outcomes may be achieved by early administration of nicorandil distal to the vascular lesion during PCI in STEMI patients.