Clinical Study of Intracoronary Injection of Sodium Nitroprusside Assisted PCI for Acute Myocardial Infarction

Han Canqun; Zhao Zhiyong

doi:10.3969/j.issn.1004-5775.2025.20.013

Abstract：Objective:To observe the clinical effect of intracoronary sodium nitroprusside injection assisted percutaneous coronary intervention(PCI)in the treatment of acute myocardial infarction(AMI).Methods:99 patients with acute myocardial infarction(AMI)admitted to Luoyang Yiluo Hospital from January 2021 to June 2023 were selected as study subjects for prospective randomized controlled study.They were divided into the conventional group(n=49)and the sodium nitroprusside group(n=50)using the random number table method.Both groups of patients were treated with emergency PCI,the conventional group was treated with intracoronary thrombus aspiration,and the sodium nitroprusside group was treated with adjuvant treatment of sodium nitroprusside via intracoronary injection on the basis of the conventional group,and the treatment effects of the two groups of patients were compared.Results:The percentage of patients in the sodium nitroprusside group with TIMI classification grade 3 and TMPG classification grade 3 was significantly higher than that of the conventional group,and the incidence of major adverse cardiovascular events(MACE)was significantly lower than that of the conventional group,with statistically significant differences(χ2=4.582,5.504,6.255;P＜0.05).Patients in the sodium nitroprusside group had lower corrected TIMI blood flow frame count(eTFC)and higher myocardial perfusion index(PI)than those in the conventional group,with statistically significant differences(t=3.089,2.404;P＜0.05).Myoglobin(MYO),creatine kinase isoenzyme(CK-MB),and lactate dehydrogenase(LDH)levels of the patients in the sodium nitroprusside group were lower than those in the conventional group,and the differences were statistically significant(t=2.449,3.938,2.439;P＜0.05).Patients in the sodium nitroprusside group had a higher left ventricular ejection fraction(LVEF)than the conventional group,and a lower left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)than the conventional group,and the differences were statistically significant(t=2.387,3.682,2.373;P＜0.05).Conclusion:The combined use of intracoronary sodium nitroprusside injection in patients with AMI undergoing PCI effectively improves myocardial microcirculatory perfusion,thereby reducing the extent of cardiomyocyte injury,accelerating the process of recovery of cardiac systolic function,and significantly decreasing the incidence of major adverse cardiovascular events.