| Objectives To evaluate curative effect of nicorandil in patients with acute ST-segment elevation myocardial infarction(STEMI)with multivessel coronary artery disease.Methods Between August 2016 to August 2017,we enrolled 150 consecutive STEMI patients with angiographic patterns of multivessel coronary artery disease at the Tang shan gong ren hospital.While the patients underwent culprit-only percutaneous coronary intervention(PCI).The non-culprit coronary artery stenosis was 50%-70% luminal narrowing.By random number table method,the patients were divided into two groups: nicorandil group and control group.The two groups were given basic treatment.On this basis,nicorandil group was treated with nicorandil 5mg three times a day at the first day after PCI,and the control group was not given special treatment.Baseline characteristics between two groups were recorded separately.Clinical follow-up was conducted for all patients at 1 and 6 months after PCI thereafter outpatient department visits.All the patients were contacted for follow-up to access number of episodes,duration,average consumption of nitroglycerin,left ventricular ejection fraction,the occurrence of malignant arrhythmia and the main adverse cardiovascular events.Results 1 At the first month after PCI,the mean number of episodes of angina pectoris(7.57±2.76)vs(9.16±3.98)and the duration(12.01±4.57)min v(14.34±4.40)min were lower in the nicorandil group(P<0.05).The average consumption of nitroglycerin was not significantly different.While the number of episodes of angina pectoris(6.06±1.09)vs(3.96±1.53)and duration(2.04±1.43)minutes vs(3.15±1.59)minutes and average weekly consumptions of nitroglycerin(2.92±1.26)tablets vs(3.89±1.63)tablets were lower in the nicorandil group at the sixth month after PCI.The difference was statistically significant(P<0.05).2 At the first month after PCI,the incidence of malignant arrhythmia in the nicorandil group and the control group was 5.5% and 16.7%,respectively,and the difference was statistically significant(P<0.05).In addition,the incidence of malignant arrhythmia in the nicorandil group and in the control group was 1.4% and 7.0%,respectively,at the 6th month.There was no significant difference(P>0.05).3 The left ventricular ejection fraction at the first month after PCI and the sixth month after PCI in the nicorandil group and the control group were(53.69±4.23)% vs(51.73±3.93)%,(57.33±3.55)% vs(54.24±3.60)%,The left ventricular ejection fraction was significantly higher in the nicorandi group(P<0.05).4 At the first and the month after PCI,the quality of life score(531.68±29.48)vs(511.64±37.84),(583.62±26.96)vs(560.81±27.77)was higher in the nicorandi group(P<0.05).5 Patients in the nicorandil group had a lower rate of re-admission for severe angina(P<0.05).There was no significant difference in acute myocardial reinfarction,revascularization,and allcause death cardiovascular events(P>0.05).Conclusions 1 Nicorandil can improve the degree of angina pectoris,incidence of malignant arrhythmia,and left ventricular function in patients with acute ST-elevation myocardial infarction complicated with multivessel disease,and can improve the quality of life and prognosis of patients.2 Nicorandil can reduce the incidence of rehospitalization for severe angina pectoris in patients with ST-segment elevation myocardial infarction complicated with multivessel disease,but it has no significant effect on prevention of acute myocardial reinfarction,revascularization,and all-cause death cardiovascular events in the six months after PCI. |
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