Effect of ticagrelor combined with nicorandil on endothelial function and coronary blood flow after PCI treatment in STEMI patients

This study investigated the effect of ticagrelor combined with nicorandil on endothelial function and coronary blood flow after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). We retrospectively analyzed 300 STEMI patients who underwent emergency PCI, 150 in the observation group and 150 in the control group. The control group was given oral ticagrelor. The observation group received oral nicorandil along with the control group. A significant improvement in peak ejection rate (PER) and left ventricular (LV) ejection fraction (EF) occurred after the operation, while LV end-diastolic volume index (LVESVI), LV end-diastolic internal diameter (LVEDD), cardiac troponin I (cTnI), and creatine kinase myoglobin (CK-MB) were significantly reduced compared to the preoperative period. Improvements in cardiac function were significantly greater in the observation group than in the control group (p < 0.05). After the operation, both groups' serum nitric oxide (NO) and endothelin-1 (ET-1) levels were greatly higher and lower, respectively, during the preoperative period (p <0.05). The observation group's serum NO level was significantly higher than the control group's, and its ET-1 level was substantially lower than the control group's (p < 0.05). There was a significant increase in thrombolysis in myocardial infarction (TIMI) flow grade 3 percentage and TIMI myocardial perfusion grade (TMPG) grade 3 percentage in the observation group in the immediate postoperative period compared to the control group, despite a significantly lower corrected TIMI Frame count (CTFC) (p < 0.05). 1 month postoperatively, major adverse cardiovascular events (MACE) incidence was significantly lower in the observation group than in the control group (chi(2) = 3.914, p = 0.048). The preoperative combination of ticagrelor and nicorandil in STEMI patients undergoing PCI helped attenuate vascular endothelial function impairment, improved coronary blood flow, and promoted postoperative cardiac function recovery.