Protection effect of nicorandil against acute kidney injury induced by contrast agent in elderly patients with AMI after PCI
Objective:To explore the protection effect of nicorandil against acute kidney injury induced by con-trast agent in elderly patients with acute myocardial infarction(AMI),following percutaneous coronary intervention(PCI).Methods:A total of 141 elderly patients with AMI undergoing PCI in the hospital were enrolled between September 2019 and October 2021.They were randomly divided into three groups:the control group,low-dose and high-dose nicorandil groups,with 47 patients in each group.The control group was given the routine treat-ment regimen(aspirin+clopidogrel+hydration therapy).On this basis,low-dose and high-dose nicorandil groups were given nicorandil(3 times/d;low-dose group:5 mg/once,high-dose group:10 mg/once)during the period from 30 min before surgery to 3 d after surgery.The renal function indexes,oxidative stress indexes,inflammato-ry indexes,mRNA related expression levels of nuclear factor erythtoid 2 related factor 2(Nrf2)/antioxidant re-sponse element(ARE)signaling pathway related genes and incidence of contrast-induced AKI were compared a-mong all groups.Results:There was significant difference in incidence of contrast-induced AKI among all groups,and the incidence of contrast-induced AKI in the control group was significantly higher than that in low-dose and high-dose nicorandil groups(P＜0.05).Compared with control group,levels of serum creatinine,urinary kidney injury molecule 1,malondialdehyde,C-reactive protein and interleukin 6 were significantly decreased,while levels of estimated glomerular filtration rate and superoxide dismutase,and mRNA related expression levels of Nrf2,ARE and heme oxygenase 1 were significantly increased in low-dose and high-dose nicorandil groups after surgery(P＜0.05).There was no significant difference in incidence of main adverse reactions among all groups(P＞0.05).Conclusion:Nicorandil may have a protective effect against contrast-induced AKI in elderly AMI patients after PCI,which may be related to that nicorandil can regulate Nrf2/ARE signaling pathways and play the roles of anti-oxidative stress and anti-inflammation.
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