Influence of nicorandil on vascular endothelial function in patients undergoing selective PCI / 心血管康复医学杂志

ABSTRACT

Objective:To study influence of nicorandil on vascular endothelial function in patients undergoing selective percutaneous coronary intervention (PCI).Methods:The 184 patients with coronary heart disease (CHD) in our de‐partment were randomly and equally divided into routine group (received selective PCI combined routine medica‐tion) and nicorandil group (received nicorandil based on routine treatment group ).Myocardial injury indexes ,levels of endothelial function indexes and inflammatory factors ,fore brachial artery endothelium dependent diastolic‐sys‐tolic function (FMD) and reactive hyperemia diameter (D1) before and after treatment ,and incidence rate of major adverse cardiovascular events (MACE) were compared between two groups .Results:Compared with routine group on 7d after PCI ,there were significant reductions in levels of cardiac troponin I (cTnI) [ (0.25 ± 0.04) ng／ml vs . (0. 22 ± 0. 03) ng／ml] ,creatine kinase isoenzyme MB (CK‐MB) [ (14.15 ± 1.52) U／L vs.(11.87 ± 1.29) U／L] , heart type fatty acid binding protein (H‐FABP) [ (0.98 ± 0.14) ng／ml vs.(0.74 ± 0.11) ng／ml] , ET‐1 [ (67. 52 ± 6.93) pg／ml vs.(51. 27 ± 5. 30) pg／ml] ,hsCRP [(5. 98 ± 0. 62) mg／L vs.(3.68 ± 0.39) mg／L] and IL‐6 [(29. 31 ± 2.97) ng／L vs .(20. 94 ± 2. 22) ng／L] ,and significant rise in level of NO [ (61. 87 ± 6.42) pg／ml vs.(86. 24 ± 8.73) pg／ml] plasminogen activator inhibitor‐1 (PAI‐1) [ (129.95 ± 14.29) ng／L vs.(141. 27 ± 15.38) ng／L] in nicorandil group , P＝ 0.001 all ; compared with routine group , there were significant rise in FMD [ (14.50 ± 1.57)% vs.(18. 70 ± 1. 92)%] and D1 [(3.85 ± 0. 46) mm vs.(3. 99 ± 0.45) mm] ,and significant reduction in in‐cidence rate of MACE (35.87% vs.9. 78%) in nicorandil group on six months after PCI , P＜0.05 or ＜0.01. Con‐clusionNicorandil can protect vascular endothelium ,reduce myocardial injury ,eliminate inflammatory factors and reduce incidence rate of MACE in patients undergoing selective PCI .