[Effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction underwent emergent percutaneous coronary intervention treatment]

Abstract

Objective: To investigate the effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with emergent percutaneous coronary intervention (PCI). Methods: A total of 120 acute STEMI patients treated with emergent PCI in our hospital from January 2015 to June 2016 were randomly divided into control group and experiment group (n=60 each). Patients in both groups received conventional therapy.Patients in experiment group took 10 mg nicorandil orally before PCI and received oral nicorandil treatment (15 mg/d, three times daily) for 3 days.QT disperse(QTd), correct QTd(QTcd) and the occurrence rate of ventricular arrhythmia were compared between two groups. Results: QTd at 6, 24, 48 and 72 hours((70.6±4.4), (67.2±5.3), (55.7±8.5), (48.2±8.2) ms, respectively) after PCI was significantly lower in the experiment group than those of control group ((77.1±7.1), (71.3±6.5), (65.1±8.1), (57.2±5.4) ms, all P<0.05). The level of QTd was also significantly lower in the experiment group at 6, 24, 48 and 72 hours((77.5±7.7), (67.7±8.6), (61.2±7.5), (52.9±8.4) ms, respectively) after PCI comared to those of control group ((88.6±8.1), (79.2±7.8), (74.4±7.4), (69.6±8.6) ms, all P<0.05). There was no significant difference in the incidence of reperfusion arrhythmia during PCI procedure between the two groups.The prevalence of the ventricular premature beat in the experiment group (25/60, 41.7%) was significantly lower than in the control group(45/60, 75.0%) within 3 days after PCI(P<0.01), the prevalence of the no sustained ventricular tachycardia and ventricular fibrillation in the experiment group(6/60, 10.0%) was also significantly lower than in the control group (18/60, 30.0%, P<0.01) within 3 days after PCI. Conclusions: Nicorandil use prior and post PCI could decrease the occurrence rate of ventricular arrhythmia in STEMI patients undergoing emergent PCI, and this effect might be related with reduced QTd and QTcd post medication.

Keywords: Angioplasty; Arrhythmias, cardiac; Myocardial infarction; Nicorandil.