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预防性注射尼可地尔减少急性 STEMI 患者 PCI 术中无复流现象:一项双盲、随机、安慰剂对照试验方案。

Prophylactically injection of Nicorandil to reduce no-reflow phenomenon during PCI in acute STEMI patients: Protocol of a double-blinded, randomized, placebo-controlled trial.

机构信息

Chongqing Dazu District People's Hospital, Chongqing, China.

出版信息

Medicine (Baltimore). 2021 Apr 16;100(15):e25500. doi: 10.1097/MD.0000000000025500.

Abstract

INTRODUCTION

An acute ST-elevation myocardial infarction (STEMI) is a very serious type of heart attack and a profoundly life-threatening medical emergency, and percutaneous coronary intervention (PCI) is the preferred strategy. However, in patients undergoing primary PCI, 30% to 40% may suffer the no-reflow phenomenon (NRP), and it could expand the myocardial infarction area and accompanied with high rehospitalization rate and fatality rate. In this study, we try to conduct a double blinded, randomized, placebo-controlled trial to observe whether the prophylactically intracoronary administration of Nicorandil could reduce the occurrence of NRP in STEMI patients undergoing PCI.

METHODS

Simple randomization in a 1:1 ratio will be made in blocks of variable size according to a random numbers generated by Excel 2010 to divide the patients to treatment group (Nicorandil) and control group (Saline). The outcomes are the occurrence of NRP, levels of interleukin-6 and HS-CRP, cTnT, and CK-MB before, and every 4 hours following PCI, and major adverse cardiovascular events at day 30. SPSS 23.0 (IBM, Chicago, IL) will be used, and P-value < .05 will be considered statistically significant.

CONCLUSIONS

The findings will determine the efficacy of prophylactically intracoronary administration of Nicorandil to reduce the occurrence of NRP during PCI in acute STEMI patients.

TRIAL REGISTRATION

OSF Registration number: DOI 10.17605/OSF.IO/QPF3V.

摘要

简介

急性 ST 段抬高型心肌梗死(STEMI)是一种非常严重的心脏病发作,是一种严重的危及生命的医疗紧急情况,经皮冠状动脉介入治疗(PCI)是首选策略。然而,在接受直接 PCI 的患者中,30%至 40%可能会出现无复流现象(NRP),这可能会扩大心肌梗死面积,并伴有高再住院率和死亡率。在这项研究中,我们试图进行一项双盲、随机、安慰剂对照试验,以观察预防性冠状动脉内给予尼可地尔是否可以减少 STEMI 患者 PCI 后 NRP 的发生。

方法

根据 Excel 2010 生成的随机数,采用大小可变的区组随机化,以 1:1 的比例将患者分为治疗组(尼可地尔)和对照组(生理盐水)。结局指标为 NRP 的发生情况,以及 PCI 前后每 4 小时的白细胞介素-6 和高敏 C 反应蛋白、cTnT 和 CK-MB 水平,以及 30 天时的主要不良心血管事件。采用 SPSS 23.0(IBM,芝加哥,IL)进行统计分析,P 值<0.05 为有统计学意义。

结论

这些发现将确定预防性冠状动脉内给予尼可地尔是否可以降低急性 STEMI 患者 PCI 期间 NRP 的发生。

试验注册

OSF 注册号:DOI 10.17605/OSF.IO/QPF3V。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9809/8052050/3ae4465ec663/medi-100-e25500-g001.jpg

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