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| Effect of Intracoronary Micorandil Injection on slow/no-reflow Flow and Risk Factors in Patients with NSTEMI Undergoing Percutaneous Coronary Intervention |
| SONG Changlai, FU Xin, SUN Jiangtao |
| The First Affiliated Hospital of Xinjiang Medical University, Changji Branch, Xinjiang Changji 831100, China |
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Abstract Objective: To investigate the effect and risk factors of intracoronary injection of nicorandil on slow flow / no reflow during percutaneous coronary intervention in patients with NSTEMI. Methods: 110 patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) admitted to our hospital from June 2016 to June 2018 were divided into control group and experimental group according to TIMI shunt of target lesions after percutaneous coronary intervention. Among them, patients with TIMI no more than grade 2, i.e. slow flow/no reflow, were divided into experimental group (25 cases), while patients with TIMI grade 3, i.e. patients with normal reflow, were divided into control group (85 cases). The general data of two groups of patients were recorded, and the related indicators of coronary interventional surgery in two groups were observed, the occurrence of major adverse cardiac events in two groups during hospitalization were compared, and the blood flow indicators before and after the application of nicorandil in the experimental group were analyzed. Logistic regression analysis was used to analyze the related factors affecting slow/no-reflow flow during interventional procedures. Results: The proportion of patients with hyperlipidemia, diabetes history, smoking history, etc. in the experimental group was significantly higher than that of the control group (P<0.05). There was no significant difference in the intraoperative center rate between the two groups (t=0.241, P>0.05). The thrombus signs and incidence of intraoperative hypotension in the experimental group were significantly higher than those in the control group (χ2=8.273, χ2=6.394, χ2=6.028, t=22.349, χ2=5.273, all P<0.05). During the hospitalization period, 1 patient in the experimental group died due to cardiogenic shock, and there was no recurrence of myocardial infarction in both groups and no significant difference in the incidence of major cardiac adverse events in the two groups (all P>0.05). The ratio of TMPG3 level and TIMI blood flow level 3 in the experimental group was significantly higher than that before the treatment in this group (χ2=47.232, χ2=53.234, P<0.05). After treatment with nicorandil, CTFC of the experimental group was significantly lower than that of this group (t=8.273, P<0.05). Thrombosis, multiple stents, intraoperative hypotension, diabetes history, and smoking history were all risk factors for slow blood flow/no complex flow (all P<0.05). Conclusion: Thrombosis, signs of hypotension, multiple stents, history of diabetes mellitus and smoking during PCI are all related risk factors affecting the occurrence of slow/no-reflow coronary flow in patients with NSTEMI. Intracoronary nicorandil injection can effectively improve slow/no-reflow coronary flow in patients with NSTEMI.
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2019, Vol. 25 
