Effects of intracoronary injection of nicorandil on coronary artery perfusion and microvascular function in patients undergoing percutaneous coronary intervention for coronary heart disease
Objective To investigate the effects of intracoronary injection of nicorandil on coronary artery perfusion and microvascular function in patients undergoing percutaneous coronary intervention(PCI)for coronary heart disease.Methods In this study,a total of 108 patients with coronary heart disease who were diagnosed and treated in Hangzhou Ninth People's Hospital from January 2022 to September 2023 were randomly divided into a control group(54 cases)and an observation group(54 cases)according to different administration methods.All pa-tients underwent routine treatment,and the observation group needed further injection of nicorandil into their coro-nary arteries.The color Doppler ultrasound diagnostic instrument was applied to measure the left ventricular ejec-tion fraction(LVEF)of patients;the maximal oxygen uptake(VO2max)was detected by cardiopulmonary exercise function instrument.Six-minute walking test(6MWT)was used to measure the walking distance of patients in 6 minutes;the thrombolysis in myocardial infarction(TIMI)blood flow grading was performed for all patients and the corrected TIMI frame count(CTFC)was recorded;slow blood flow and no reflow were localized based on the num-ber of CTFC frames;enzyme linked immunosorbent assay(ELISA)was applied to detect the level of endothelin-1(ET-1)in serum;Luminescent immunoassay was applied to detect the level of nitric oxide(NO)in serum;im-munoturbidimetry was applied to detect von Willebrand factor(VWF);clinical efficacy was evaluated based on the evaluation criteria for electrocardiogram efficacy.Results After treatment,the LVEF[(38±5)％],6MWT[(396±96)m],and VO2max[(21.7±3.7)L/min]in the observation group increased significantly compared to the control group[(35±5)％,(357±88)m,(18.4±2.9)L/min](t=2.875,2.228,5.192,P＜0.05).The percentage of TIMI Ⅲ patients in the control group was lower than that in the observation group,and the percentage of slow blood flow patients was higher than that in the observation group.CTFC was under than that in the control group(P＜0.05).The increase in NO levels,as well as the decrease in VWF and ET-1 levels in the observation group were greater than those in the control group(P＜0.05).The total effective rate of the observation group(96％)was significantly higher than that of the control group(74％)(x2=10.567,P＜0.001).Conclusion Intracoronary injection of nicorandil can effectively improve coronary artery perfusion and microvascular function in patients with coronary heart disease undergoing PCI,with significant therapeutic effects.
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