Effect of nicorandil on the clinical prognosis of patients with angina pectoris after percutaneous coronary intervention for acute coronary syndrome

Xiang Shouping; Yang Chen; Li dandan; Wang Jinda

doi:10.3969/j.issn.1674-3245.2025.01.011

Abstract：Objective To investigate the effect of nicorandil on the prognosis and inflammatory response of patients with angina pectoris after coronary intervention(PCI)for acute coronary syndrome,and to provide reference for clinical work.Methods A retrospective case-control study was conducted on 230 patients with acute coronary syndrome complicated with angina pectoris after PCI in the Sixth Medical Center of PLA General Hospital from January 2019 to December 2021.They were divided into the nicorandil group(102 cases)and the control group(128 cases)according to the actual medication situation.The follow-up data were carefully collated and analyzed.At the 4-week follow-up,the baseline characteristics,clinical symptoms,cardiac function indicators,and levels of inflammatory factors of the two groups were compared.At the 1-year follow-up,the occurrence of major adverse cardiovascular events(MACE),adverse reactions,health status,and the re-hospitalization rate due to angina were compared between the two groups.Results After 4 weeks of follow-up,the frequency and duration of angina pectoris in the nicorandil group decreased compared with the control group(t=6.25,-3.53;P<0.05).At the same time,the levels of B-type brain natriuretic peptide(BNP),left ventricular end-diastolic diameter(LVEDD),E/e'on the interventricular septum side,and E/e'on the lateral wall side in the nicorandil group were significantly decreased compared with the control group(t=2.76,-3.55,2.48,4.41;P<0.05).The levels of interleukin-6(IL-6),high-sensitive C-reactive protein(hs-CRP),and tumor necrosis factor α(TNF-α)in the nicorandil group were significantly decreased compared with the control group(t=-2.210,-2.054,5.280;P<0.05).At 1 year of follow-up,the health status score of the nicorandil group was higher than that of the control group(t=2.33;P=0.02),and the rate of re-hospitalization due to angina pectoris was lower than that of the control group,with statistical significance(χ2=4.87;P<0.05).The incidence of adverse reactions in the nicorandil group(11.54%)and the control group(16.41%)showed no significant difference(P>0.05).The incidence of MACE events in the nicorandil group was lower than that in the control group,and the difference was statistically significant(χ2=7.95;P<0.05).Multivariate logistic regression results suggested that nicorandil was a protective factor for MACE events in patients with angina pectoris after PCI(P<0.05).Conclusion The application of nicorandil in patients with angina pectoris after PCI for acute coronary syndrome is highly effective,which can effectively relieve clinical symptoms,improve cardiac function,and reduce the levels of inflammatory factors.Long-term application can reduce the occurrence of MACE events,significantly improve the quality of life of patients,reduce the rate of re-hospitalization of angina pectoris,and has high safety.