The effects of nicorandil on clinical outcome after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction / 天津医药

ABSTRACT

@#Objective Toevaluatetheeffectsofcombinedintracoronaryandintravenous administrationofnicorandil onmyocardialmicrocirculationandshort-termprognosisinpatientswithacuteST-segmentelevationmyocardialinfarction (STEMI)treatedwithprimarypercutaneouscoronaryintervention(PPCI). Methods Atotalof100patientswithacute STEMIunderwentPPCIwererandomlydividedintothenicorandilgroup(patientsreceivedintracoronarybolusinjectionof nicorandilwhenthetargetvesselopenedandthencontinuousintravenousinfusionwithin24hours, n=50)andthecontrol group(patientsreceivednormalsalineascontrol, n=50).Themainoutcomemeasureswereimmediatecoronaryflowand myocardialperfusionafterPPCI,includingthrombo-Lysisinmyocardialinfarction(TIMI)flowgrade,correctedTIMIframe count(CTFC),reperfusionarrhythmia,ST-segmentresolution,plasmacreatinekinaseisoenzyme(CK-MB)peakvalueand time. The secondary indicators were major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF)duringhospitalization.Results Therewerenosignificantdifferencesinhepatorenalfunction,heartrateandblood pressurebeforeandafteroperationineachgroup(P＞0.05).Theincidenceofreperfusionarrhythmia,thelevelofMACE, CTFC,andpeakvalueofCK-MBwereallsignificantlylowerinthenicorandilgroupcomparedwiththoseofcontrolgroup (P＜0.05).TheproportionsofpatientswithTIMI3flow,CK-MBpeaktimein14hours,andtheproportionofST-segment resolutionweresignificantlyhigherinthenicorandilgroupthanthoseofthecontrolgroup(all P＜0.05).Therewasno significant difference in LVEF during hospitalization between two groups (P＞0.05). Conclusion Intracoronary and intravenousadministrationofnicorandilcansignificantlyimproverevascularizationeffects,reducetheoccurrenceofslow flow/noreflow,limitmyocardialinfarctionsize,increasemyocardialperfusionandimprovemyocardialmicrocirculationand theshort-termprognosisofacuteSTEMIpatients.