Effect of continuous intravenous injection of nicorandil on ventricular arrhythmias after acute ST-segment elevation myocardial infarction: A randomized controlled trial
- Journal of Army Medical University Vol. 47, Issue 24, Pages: 3112-3119(2025)
- 作者机构：
重庆市急救医疗中心/重庆大学附属中心医院心血管内科，重庆
- 作者简介：
CHEN Chuan，E-mail：467025658@qq.com
- 基金信息：the Medical Research Project of Chongqing Health Commission(2024WSJK108);the 2023Construction Project for Key Disciplines on Public Health in Chongqing.
DOI：10.16016/j.2097-0927.202509047
CLC： R540.1;R542.22;R972Received：13 September 2025，
Revised：2025-12-09，
Published：30 December 2025
- 稿件说明：
移动端阅览
徐刚，李传伟，汪浩，等.持续静脉应用尼可地尔对急性 ST 段抬高型心肌梗死后室性心律失常的影响：一项随机对照研究［J］.陆军军医大学学报，2025，47（24）：3112-3119.DOI：10.16016/j.2097-0927.202509047.
XU G，LI C W，WANG H，et al.Effect of continuous intravenous injection of nicorandil on ventricular arrhythmias after acute ST-segment elevation myocardial infarction： A randomized controlled trial［J］.J Army Med Univ，2025，47（24）：3112-3119.DOI：10.16016/j.2097-0927.202509047.
徐刚，李传伟，汪浩，等.持续静脉应用尼可地尔对急性 ST 段抬高型心肌梗死后室性心律失常的影响：一项随机对照研究［J］.陆军军医大学学报，2025，47（24）：3112-3119.DOI：10.16016/j.2097-0927.202509047. DOI：
XU G，LI C W，WANG H，et al.Effect of continuous intravenous injection of nicorandil on ventricular arrhythmias after acute ST-segment elevation myocardial infarction： A randomized controlled trial［J］.J Army Med Univ，2025，47（24）：3112-3119.DOI：10.16016/j.2097-0927.202509047. DOI：
摘要
目的
2
探讨围术期持续静脉应用尼可地尔对急性 ST 段抬高型心肌梗死（ST-segment-elevation myocardial infarction， STEMI）后室性心律失常（ventricular arrhythmia， VA）的影响。
方法
2
本研究为一项随机对照试验，纳入2024年1月至2025年5月我院心血管内科收治的行急诊经皮冠状动脉介入治疗（percutaneous coronary intervention， PCI）的STEMI 患者140例，采用随机数表法将患者分为对照组（
n
=70）和尼可地尔组（
n
=70），尼可地尔组于急诊 PCI 术前静脉推注6 mg尼可地尔作为负荷剂量，继之以6 mg/h的速度持续静脉滴注48 h；对照组给予生理盐水，用法用量与尼可地尔组一致。比较两组住院期间 VA（包括频发性室性早搏、非持续性室性心动过速、持续性室性心动过速、心室扑动及心室颤动）及主要不良心血管事件（major adverse cardiovascular events， MACE）的发生情况。
结果
2
尼可地尔组 VA 的总体发生率显著低于对照组（31.4%
vs
58.6%，
P
=0.001）；尼可地尔组MACE的发生率
较对照组略低，但差异无统计学意义（15.7%
vs
27.1%，
P
=0.099）。多因素Logistic回归分析显示，尼可地尔是VA发生的独立保护因素（
OR
=0.205， 95%
CI
： 0.083~0.506，
P
=0.001）。亚组分析提示，尼可地尔的保护作用在年龄
<
65岁、无糖尿病及Killip I级的患者中尤为显著。
结论
2
在 STEMI 常规治疗方案基础上，于 PCI 围术期持续静脉应用尼可地尔可有效降低住院期间室性心律失常的发生率。
Abstract
Objective
2
To investigate the effect of continuous intravenous nicorandil administration during the perioperative period on ventricular arrhythmia (VA) in patients with acute ST-segment elevation myocardial infarction (STEMI).
Methods
2
A randomized controlled trial was conducted on 140 patients with acute STEMI undergoing emergency percutaneous coronary intervention (PCI) in our department from January 2024 to May 2025. They were randomly allocated into a control group (
n
=70) and a nicorandil group (
n
=70). The nicorandil group received an intravenous bolus of 6 mg nicorandil as a loading dose before emergency PCI
followed by a continuous intravenous infusion at 6 mg/h for 48 h. The control group received normal saline following the same dosage and administration schedule. The incidences of in-hospital VA (including frequent ventricular premature beats
non-sustained ventricular tachycardia
sustained ventricular tachycardia
ventricular flutter
and ventricular fibrillation) and major adverse cardiovascular events (MACE) were compared between the 2 groups.
Results
2
The total incidence of VA (31.4%
vs
58. 6%
P
=0.001) was significantly lower in the nicorandil group than in the control group. The incidence of MACE was slightly lower in the nicorandil group compared to the control group
but the difference did not reach statistical significance (15.7%
vs
27.1%
P
=0.099). Multivariate logistic regression analysis indicated
that nicorandil was an independent protective factor against VA (
OR
=0.205
95%
CI
: 0.083~0.506
P
=0.001). Subgroup analysis suggested that the protective effect of nicorandil was particularly significant in patients aged
<
65 years
without diabetes
and with Killip class I.
Conclusion
2
Based on conventional STEMI treatment regimen
continuous intravenous administration of nicorandil during the peri-PCI period effectively reduces the incidence of in-hospital VA.
关键词
Keywords
references
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