Application of ticagrelor combined with nicorandil in percutaneous coronary intervention for acute myocardial infarction
Objective To explore the application effect of ticagrelor combined with nicorandil in percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods 80 AMI patients were selected from the People's Hospital of Qiannan Buyi and Miao Autonomous Prefecture of Guizhou Province from March 2021 to June 2024,and they were randomly divided into the conventional group and the combined group according to random number table method,with 40 cases in each group.All patients were treated with PCI,and the conventional group was provided with aspirin combined with ticagrelor antiplatelet therapy,while the combined group was added with nicorandil on the basis of the conventional group.The clinical efficacy indexes[corrected TIMI frame count(cTFC)immediately after surgery,ST-segment resolution rate within 4 hours after surgery,incidence rate of no-reflow phenomenon(NRP)immediately after surgery],thrombolysis in myocardial infarction(TIMI)blood flow grading,cardiac function indexes[left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESd)]and myocardial injury markers[creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),cardiac troponin I(cTnI)]before surgery and at 7 days after surgery and incidence rates of bleeding events and major adverse cardiovascular events(MACE)during hospitalization were compared between both groups.Results The cTFC immediately after surgery,incidence rate of NRP immediately after surgery and incidence rate of total MACE with(24.16±3.81,7.50%,12.50%)in the combined group were lower than(30.47±4.22,27.50%,32.50%)in the conventional group(P＜0.05).The ST-segment resolution rate within 4 hours after surgery was higher in the combined group than that in the conventional group(67.50%vs.40.00%,P＜0.05).There was a significant difference in TIMI blood flow grading between groups at 7 days after surgery(P＜0.05).LVESd,LVEDd,CK-MB,LDH and cTnI in the two groups were decreased at 7 days after surgery(P＜0.05),and the above indexes in the combined group were lower than those in the conventional group(P＜0.05).At 7 days after surgery,LVEF was enhanced in both groups(P＜0.05),and the LVEF in the combined group was higher than that in the conventional group(P＜0.05).Conclusion Ticagrelor combined with nicorandil has exact efficacy on AMI patients during PCI,and it can promote the recovery of coronary blood perfusion,improve the cardiac function,relieve the degree of myocardial injury,and also help to reduce the risk of postoperative MACE.
Acute myocardial infarctionPercutaneous coronary interventionTicagrelorNicorandilCardiac function
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