The myocardial protective effect of nicorandil preoperative intervention on patients with heart disease undergoing hip arthroplasty / 中国医师进修杂志

ABSTRACT

Objective:To explore the myocardial protective effect of nicorandil preoperative intervention on patients with heart disease undergoing hip replacement surgery.Methods:The case data of 117 patients undergoing hip arthroplasty in Rugao Branch Affiliated Hospital of Nantong University from June 2018 to December 2020 were retrospectively analyzed. According to whether nicorandil was given before surgery, they were divided into two groups. The group A and group B was given routine preoperative general anesthesia, and the group B was given nicorandil before surgery. The surgery-related indicators, inflammatory factors, myocardial damage, major adverse cardiac events (MACE) werecompared between the two groups.Results:The operation time, intraoperative blood loss, intraoperative fluid rehydration, urine output, Ramsay sedation score on the first day after surgery, visual analogue scale (VAS) score on the first day after surgery, and hospital stay in the two groups had no significant differences ( P>0.05). The levels of serum interleukin-6, tumor necrosis factor -α, C-reactive protein, cardiac troponin I, creatine kinase-MB, myoglobin andipoprotein associated phospholipase A2 postoperative in group B were lower than those in the group A (388.15 ± 56.20) μg/L vs. (456.34 ± 65.18) μg/L, (34.24 ± 8.90) μg/L vs. (40.26 ± 10.22) μg/L, (27.54 ± 5.52) mg/L vs. (30.25 ± 5.61) mg/L, (0.10 ± 0.05) μg/L vs. (0.19 ± 0.08) μg/L, 0.059 ± 0.019 vs. 0.099 ± 0.026, (68.41 ± 6.03) μg/L vs. (76.61 ± 6.54) μg/L, (201.67 ± 25.88) μg/L vs. (251.37 ± 31.06) μg/L, the differences were statistically significant ( P<0.05). There was no statistically significant difference in the total incidence of MACE between the two groups ( P>0.05). Conclusions:Nicorandil intervention before hip replacement surgery can effectively improve the levels of inflammatory factors in patients with heart disease and reduce the degree of myocardial damage.Whether it can reduce the risk of MACE after surgery still needs to be further demonstrated.