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Effect of continuous intravenous injection of nicorandil on ventricular arrhythmias after acute ST-segment elevation myocardial infarction: A randomized controlled trial
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Gang XU, Chuanwei LI, Hao WANG, Guoying KAO, Jun LI, Yi XU, Chuan CHEN
Journal of Army Medical University | 2025, 47(24) : 3112 - 3119
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Journal of Army Medical University | 2025, 47(24): 3112-3119
• Clinical Medicine •
Effect of continuous intravenous injection of nicorandil on ventricular arrhythmias after acute ST-segment elevation myocardial infarction: A randomized controlled trial
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Gang XU, Chuanwei LI, Hao WANG, Guoying KAO, Jun LI, Yi XU, Chuan CHEN
Affiliations
  • 1Department of Cardiovascular Medicine,Chongqing Emergency Medical Center • Chongqing University Central Hospital,Chongqing,China
Published: 2025-12-30 doi: 10.16016/j.2097-0927.202509047
Outline
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Objective

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

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

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

Based on conventional STEMI treatment regimen, continuous intravenous administration of nicorandil during the peri-PCI period effectively reduces the incidence of in-hospital VA.

nicorandil  /  acute ST-segment elevation myocardial infarction  /  ventricular arrhythmia
徐刚, 李传伟, 汪浩, 考国营, 李均, 徐艺, 陈川. 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. 陆军军医大学学报, 2025 , 47 (24) : 3112 -3119 . DOI: 10.16016/j.2097-0927.202509047
Gang XU, Chuanwei LI, Hao WANG, Guoying KAO, Jun LI, Yi XU, Chuan CHEN. Effect of continuous intravenous injection of nicorandil on ventricular arrhythmias after acute ST-segment elevation myocardial infarction: A randomized controlled trial[J]. Journal of Army Medical University, 2025 , 47 (24) : 3112 -3119 . DOI: 10.16016/j.2097-0927.202509047
Year 2025 volume 47 Issue 24
35
14
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doi: 10.16016/j.2097-0927.202509047
  • Receive Date:2025-09-13
  • Online Date:2026-10-30
  • Published:2025-12-30
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History
  • Received:2025-09-13
  • Revised:2025-12-09
Affiliations
    1Department of Cardiovascular Medicine,Chongqing Emergency Medical Center • Chongqing University Central Hospital,Chongqing,China
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表12种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
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属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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