| Objective: To investigate the effect of intracoronary injection of nicorandil on slow blood flow/no-reflow and short-term prognosis in acute ST-segment elevation myocardial infarction(STEMI)patients with percutaneous coronary intervention(PCI).Methods: A total of 60 STEMI patients with emergency PCI from September 2018 to September 2019 in the First People’s Hospital of Nanning were selected.There were 37 male patients and 23 female patients,and the age of all patients was 36 to 86 years.According to the used drug in the coronary artery,the patients were divided into two groups,group A and group B,and there were 30 patients in each group,each patient was given a dose of aspirin(300mg),clopidogrel(300mg)and vastatin calcium(40mg)before PCI.In addition,unfractionated heparin(80～100U/kg)was injected through the arterial sheath;group A was nicorandil group [6mg nicorandil was diluted with 0.9%sodium chlodide solution 10 ml,a dose of 3mg nicorandil was injected into the coronary artery after balloon dilatation and stent implantation,respectively,and a treatment of nicorandil(12mg)added into 0.9% sodium chlodide solution50 ml was carried out in intravenously administration via micro-pump(with a speed of 25ml/h,a total amount of nicorandil was 36mg)for 6 hours after PCI)],Group B was nitroglycerin group [after guide wire or balloon passes infarct related artery(IRA),200μg of nitroglycerin was injected through arterial sheath and thenexpand the balloon and Stent Placement],Coronary angiography results of reflowed blood vessels were observed after the drug injection into target blood vessel for 5 minutes,The blood flow grading of the target blood vessel Thrombolysis in Myocardial Infarction(TIMI)was evaluated,and the corrected TIMI blood flow frames(CTFC)was calculated to evaluate the target vessel blood flow rate after PCI,and an observation of the occurrence of no reflow/slow blood flow during operation,the number of cases of ST segment complete fallback after PCI for 2 hour,Serum creatine kinase isoenzyme-MB(CK-MB)and troponin(c TNI)were detected and Electrocardiogram(ECG)examination was performed after 24 hours of PCI;N-terminal brain natriuretic peptide precursor(NT-pro BNP)was detected,left ventricular ejection fraction(LVEF)and ECG examination was performed after a week of PCI;A total number of cases of major adverse cardiovascular events(MACE)was counted with 3 months after PCI.Results: The incidence of postoperative no-reflow/slow blood flow was6.7%-in group A,23.2% in group B,90.0% in group A after electrocardiogram completely dropped,and 66.7% in group B.There was no reflow/ Compared with group A,the incidence of slow blood flow was significantly lo-wer than that of group B,and the complete electrocardiogram drop rate was significantly greater than that of group B.The difference between NT-pro BNP,CK-MB,and c TNI before and after surgery was statistically sig-nificant(P<0.05).However,there was no statistically significant difference in CK-MB and c TNI between the two groups(P>0.05);comparing the electrocardiograms of the two groups of patients at 1 week after operation,the incidence of arrhythmia in group A was23.3%,the incidence of arrhythmia in group B was 33.3%,and group A The incidence of arrhythmia was lower than that in group B.The patients in the two groups were followed up for 3 months respectively.The incidence of MACE in group A was 33.3%,and the incidence of MACE in group B was 70.0%.It has statistical significance(P<0.05).Conclusion: Intracoronary injection of nicorandil in STEMI patients during PCI can effectively improve the postoperative cardiac function and the shortterm prognosis of patients.However,there was no significant effect on reducing the occurrence of slow blood flow/no-reflow in PCI. |
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