Effects Of Nicorandil On Contrast-Induced Nephropathy In Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Objective: To evaluate the effect of nicorandil on the incidence of contrast-induced nephropathy(CIN)in patients with acute coronary syndrome undergoing percutaneous coronary intervention(PCI).Methods: Collect all the data of patients who consistent with selected condition,including gender,age,height,weight,admission blood pressure,blood routine test,hepatic function,blood lipid,blood creatinine,cystatin C,family history,hypertension history,diabetes history,basic drugs and Mehran scores.The patients were randomly divided into the conventional treatment group as control group(n=39,male/female=22/17)and nicorandil group(n=36,male/female=26/10).Conventional treatment group was given aspirin,clopidogrel,β-blockers,ACEI/ARB,statins,isosorbide mononitrate;nicorandil group was given aspirin,clopidogrel,β-blockers,ACEI/ARB,statins,isosorbide mononitrate,nicorandil(5mg tid).Interventional procedures all use of nonionic contrast agent ioversol.Blood samples were collected at baseline and on hours 24 and 48 after the procedure for the measurement of serum Cr and cystatin C levels.Observation index: Comparison of the basic data of patients at admission.Changes of the level of serum Cr and cystatin C levels after procedure for 24 hours and 48 hours.Statistical methods: The data were analyzed by SPSS21.0,there is significant difference when P < 0.05.Result: 1 Comparison of basic data: Comparison of the basic data of patients at admission between two group,measurement data including age,height,weight,hematocrit,hemoglobin,serum Cr and cystatin C,left ventricular ejection fraction,body mass index(BMI),glomerular filtration rate(GFR),Mehran scores were analyzed by t test,the results are all P>0.05,no significant differences and the count data including gender,hypertension,diabetes,smoking history and drinking history,and basic drugs including aspirin,clopidogrel,β-blockers,ACEI/ARB,statins,isosorbide mononitrate,were analyzed by chi square test,all P>0.05,no statistical significance;2 Comparison of the incidence of contrast-induced nephropathy(CIN): According to the definition of CIN that as >0.5 mg/dL increase or >25% rise in serum Cr(SCr)concentration within 48 hours of contrast exposure compared to baseline.There were 39 persons in the conventional treatment group,the cases of CIN were 1 people(2.6%).The case is 1(2.8%)with CIN in the nicorandil group(n=36).Comparison with two groups,the P=0.954,no statistical significance;3 Comparison of the level of cystatin C:Comparing of cystatin C levels with patients in the two groups,after procedure for 24 hours,they were 0.944±0.153 vs 0.928±0.111,P=0.608,no statistical significance;and after procedure for 48 hours 0.977±0.161 vs 0.941±0.157,P=0.322,no statistical significance.Conclusion: There were no obvious preventive effect of nicorandil on the incidence of contrast-induced nephropathy(CIN)in patients with acute coronary syndrome undergoing percutaneous coronary intervention.