Résumé
Objectives: To observe the preventive effects of combined nicorandil with trimetazidine strategy on contrast-induced nephrophathy in patients undergoing elective percutaneous coronary intervention (PCI). Methods: 521 patients with acute coronary syndrome undergoing elective PCI were randomly divided into 4 groups:control group (n=208), nicorandil group (n=105), trimetazidine group (n=104), nicorandil plus trimetazidine group (n=104). The control group received hydration and aspirin, β-blockers, statins and other conventional drugs for coronary heart disease. The remaining three groups were given respective medication on top of the medications used in control group at 48 hours prior to PCI. The levels of respective blood index were measured and compared among four groups at preoperative and at 72 hours post operation. The primary endpoint was the incidence of CIN. Results: The incidence of contrast-induced nephropathy (CIN) in the control group, nicorandil group, trimetazidine group, nicorandil plus trimetazidine group were 8.2%, 2.8%, 3.8%, 1.0% respectively, which was significantly lower in nicorandil plus trimetazidine group than in the control group (P=0.009). Multivariate logistic regression analysis showed that, compared with control group, the use of nicorandil plus trimetazidine strategy was related to decreased CIN incidence (OR=0.114, 95%CI: 0.015-0.880, P=0.037). Conclusions: In patients with acute coronary syndrome undergoing elective PCI, the use of nicorandil plus trimetazidine strategy is related to decreased CIN incidence.