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Intravenous Nicorandil in STEMI Patients Undergoing Primary PCI: Insights from the CLEAN Randomized Clinical Trial and Broader Evidence
The CLEAN trial shows intravenous nicorandil adjunctive to primary PCI does not significantly improve 12-month clinical outcomes in STEMI. Evidence suggests microvascular benefits but no consistent long-term mortality or infarct size reduction, challenging routine use in unselected patients.