Prognostic Value of Myocardial Perfusion SPECT After Intravenous Bolus Administration of Nicorandil in Patients with Acute Ischemic Heart Failure

Clinical Effect of Nicorandil Combined with Aspirin in the Treatment of Myocardial Ischemia

Objective

To investigate the clinical effect of nicorandil combined with aspirin in the treatment of myocardial ischemia.

Methods

A total of 104 patients with myocardial ischemia were admitted to our hospital from June 2019 to August 2020. These patients were selected as the research objects and randomly divided into two groups: the control group and the observation group. The control group was given asilin, and the observation group was given nicorandil tablets based on the control group. Both groups were given continuous treatment for 3 months. The curative effect, cardiac function indexes, dynamic electrocardiogram, and the occurrence of adverse reactions were observed in the two groups.

Results

The total effective rate of the observation group was 96.15% (50/52), which was higher than that of the control group (61.54%, 32/52), and the difference was statistically significant (P < 0.05). After treatment, left ventricular ejection fraction (LVEF) and peak early/late diastolic flow velocity (E/A) were increased (P < 0.05), while peak early diastolic flow velocity to peak mitral annular root movement velocity (E/Ea) was decreased (P < 0.05). After treatment, LVEF and E/A in the observation group were higher than those in the control group, while E/Ea was lower than that in the control group (P < 0.05). The frequency, duration of ST segment, and a total load of myocardial ischemia in the ST segment within 24 h after treatment were decreased compared with those before treatment (P < 0.05). The frequency and duration of ST segment decreased, and the total load of myocardial ischemia in the observation group was lower than those in the control group within 24 h after treatment (P < 0.05). After treatment, the total occurrence of adverse reactions in the observation group was lower than that in the control group (P < 0.05).

Conclusion

Nicorandil combined with aspirin in the treatment of patients with myocardial ischemia has a significant effect, which can effectively improve the electrocardiogram and cardiac function indicators of patients and reduce the incidence of adverse reactions and is worthy of clinical application.

Cardiovascular magnetic resonance image analysis and mechanism study for the changes after treatments for primary microvascular angina pectoris

ABSTRACT

Most cases of primary microvascular angina pectoris (PMVA) are diagnosed clinically, but the etiology and pathological mechanisms are unknown. The effect of routine clinical medications is minimal, and PMVA can progress to serious cardiovascular events. To improve the diagnosis and effective treatment of this disease, this study was designed to diagnose PMVA via cardiovascular magnetic resonance (CMR) and the coronary angiography thrombolysis in myocardial infarction (TIMI) blood flow grade, as well as to analyze vascular endothelial function to elucidate the pathogenesis of PMVA and compare the effects of routine clinical medications.The present randomized controlled trial including a parallel control group will be conducted on 63 PMVA patients in our cardiovascular department. The patients will be selected and randomly divided into the control, diltiazem, and nicorandil groups. The control group will be administered routine drug treatments (aspirin, atorvastatin, betaloc ZOK, perindopril, and isosorbidemononitrate sustained-release tablets). The diltiazem group will be additionally treated with 90 mg qd diltiazem sustained-release capsules. The nicorandil group was additionally given 5 mg tid nicorandil tablets. Coronary angiography will be performed before treatment, the severity and frequency of chest pain will be evaluated before and after 9 months of treatment, and homocysteine and von Willebrand factor levels will be measured. Electrocardiography, echocardiography, dynamic electrocardiography, a treadmill exercise test, and CMR will be performed. Sex, age, body mass index, complications, smoking, and family history will also be recorded. The SPSS19.0 statistical software package will be used to analyze the data. The measurements will be expressed as the mean ± standard deviation. Measurement data will be compared between the groups using Student's t-test. A relative number description will be used for the counting data, and the chi-squaretest will be used to compare the groups. A multivariate logistic regression analysis will be performed A P-value < .05 will be considered significant.The direct indices (CMR and coronary angiographic TIMI blood flow grade) may improve after adding diltiazem or nicorandil during routine drug treatments (such as aspirin, statins, and nitrates) in PMVA patients, and indirect indices (homocysteine and von Willebrand factor levels) may be reduced.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (http://www.chictr.org.cn/showprojen.aspx?proj=41894), No. CHiCTR1900025319, Registered on August 23, 2019; pre initiation.

Effect of sequential nicorandil on myocardial microcirculation and short-term prognosis in acute myocardial infarction patients undergoing coronary intervention

Background

This study aims to observe the effects of the intracoronary and peripheral venous administration of nicorandil for the postoperative myocardial microcirculation and short-term prognosis of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) treatment.

Methods

A total of 140 STEMI patients were divided into three groups according to different patterns of administration: sequential nicorandil group, intracoronary nicorandil group and control group. The main observation indexes included coronary blood flow and myocardial perfusion immediately after PPCI, while the secondary observation indexes included major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF) during the period of hospitalization.

Results

After PPCI, the difference in the proportion of patients with thrombolysis in myocardial infarction (TIMI) flow grade 3 among the three groups was statistically significant (P=0.036), where this proportion was higher in the sequential nicorandil group and intracoronary nicorandil group than in the control group (P=0.022 and P=0.047); The difference in corrected TIMI frame count (CTFC) among the three groups was statistically significant (P=0.022), where CTFC was lower in the sequential nicorandil group and intracoronary nicorandil group than in the control group (P=0.010, P=0.031); The differences in the proportion of patients with complete ST resolution (STR) and advancing of enzyme peak time to within 12 h between each two groups were statistically significant (P<0.001), where this proportion was the highest in the sequential nicorandil group; The difference in the CK-MB peak among the three groups was statistically significant (P=0.036), where the CK-MB peak was lower in the sequential nicorandil group than in the control group (P=0.012); The difference in the incidence of MACE between each two groups was statistically significant (P<0.001), where this incidence was the lowest in the sequential nicorandil group; The differences in the proportion of patients with advancing of enzyme peak time to within 14 h and LVEF among the three groups were not statistically significant (P=0.722 and P=0.284).

Conclusions

Compared with intracoronary use alone, the intracoronary and peripheral intravenous use of nicorandil can better improve myocardial microcirculation and short-term prognosis.