Curative effect and influence of nicorandil on serum cystatin C and cardiac troponin I in patients with ST-segment elevation myocardial infarction complicated by multivessel disease

Liu Lingling; Yang Ruibo; Jiao Fenghui

doi:10.3969/j.issn.1674-4055.2025.06.07

Abstract：Objective To analyze the curative effect of nicorandil in patients with acute ST-segment elevation myocardial infarction(STEMI)complicated by multivessel disease.Methods The patients with STEMI complicated by multivessel disease underwent PCI(n=206)were selected,and randomly divided into control group and test group(n=103)from the First Hospital of Handan City from May 2021 to Aug.2023.The control group was given routine treatment after PCI,and test group was additionally given nicorandil(5 mg,tid)orally.The clinical symptoms and medication status were compared between 2 groups before treatment,and after PCI for 1 month and 6 months.The changes of heart function,TIMI blood flow grading and myocardial injury indicators were compared after PCI for 1 month and 6 months.The incidence of adverse reactions during treatment and major adverse cardiovascular events(MACE)during 6-month follow-up period were counted.Results At 1 month and 6 months after PCI,the comparison of clinical symptoms and medication usage within each group at different time points showed statistical significance(P＜0.05).Moreover,all indicators in test group were lower than those in control group at both 1 month and 6 months post-PCI(P＜0.05).The comparison in heart function showed statistical significance in 2 groups between 1 month and 6 months post-PCI(P＜0.05),and there was statistical significance between 2 groups at different time points(P＜0.05).After PCI for 6 months,TIMI blood flow grads increased in 2 groups(P＜0.05).After PCI for 1 month and 6 months,myocardial injury indicators decreased significantly in 2 groups(P＜0.01),and was lower in test group than those in control group(P＜0.01).The difference in adverse reactions had no statistical significance between 2 groups(P＞0.05).After followed up for 6 months,the total incidence of MACE was lower in test group than that in control group(6.80%vs.15.53%,P＜0.05).Conclusion Nicorandil can reduce attack time of angina pectoris,relieve myocardial injury,improve heart function and reduce MACE incidence with higher safety and effectiveness in STEMI patients complicated by multivessel disease after PCI.