Nicorandil protects against coronary microembolization-induced myocardial injury by suppressing cardiomyocyte pyroptosis via the AMPK/ TXNIP/NLRP3 signaling pathway

Background: Coronary microembolization (CME) is a common and intractable complication of coronary revas-cularization, which leads to perioperative myocardial injury, cardiac dysfunction, and poor prognosis. Nicorandil is widely used for the management of ischemic heart diseases, but the cardioprotective effects of nicorandil beyond anti-angina in CME-induced myocardial injury are worthy of further exploration. Therefore, the present study investigated the effect of nicorandil on CME-induced cardiomyocyte pyroptosis and explored the under-lying mechanism.Methods: A rat model of CME was established via the injection of microspheres into the left ventricle. A cell model of H9c2 cardiomyocytes stimulated by lipopolysaccharide (LPS) and hypoxia mimicked the microenvironment induced by CME. Nicorandil or the adenosine monophosphate-activated protein kinase (AMPK)-specific inhibitor compound C (CC) was administered before CME induction and cell modeling. Cardiac function, histological alterations in the myocardium, myocardial injury biomarkers in serum and cell culture supernatant, cell viability, adenosine triphosphate (ATP) level, superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, reactive oxygen species (ROS) activity, mitochondrial membrane potential, and pyroptosis-associated index were assessed after the animal and cell modeling of CME.Results: Nicorandil pretreatment attenuated cardiac dysfunction and myocardial injury following CME. Nicor-andil also alleviated oxidative stress and mitochondrial damage. Moreover, nicorandil promoted AMPK activa-tion, reduced the expression of thioredoxin-interacting protein (TXNIP), inhibited the activation of the NOD-like receptor pyrin containing 3 (NLRP3) inflammasome, and mitigated cardiomyocyte pyroptosis. However, co -treatment with CC reversed the cardioprotective effects of nicorandil.Conclusion: Nicorandil pretreatment inhibits cardiomyocyte pyroptosis and alleviates CME-induced myocardial injury via the AMPK/TXNIP/NLRP3 signaling pathway.

Automated summary

The study showed that pretreatment with nicorandil can inhibit cardiomyocyte pyroptosis and alleviate CME-induced myocardial injury through the AMPK/TXNIP/NLRP3 signaling pathway, while also reducing oxidative stress and mitochondrial damage.