Objective To investigate effect of remote ischemic preconditioning (RIPC)combined with transcutaneous vagus nerve stimulation (tVNS) on reperfusion injury in ST-segment elevation myocardial infarction (STEMI).

Methods A total of 132 STEMI patients were selected, and were randomly divided into control group, tVNS group and combined group (RIPC combined with tVNS) before percutaneous coronary intervention (PCI). A total of 9 of the 132 patients were excluded, including 42 in the control group, 40 in the tVNS group, and 41 in the combination group. The area under the curve (AUC) of creatine kinase isoenzyme (CK-MB) within 72 h and the ventricular arrhythmia (VAs) within 24 h after reperfusion were compared among the three groups. The levels of interleukin-6 (IL-6), high mobility group protein B1(HMGB1), tumor necrosis factor-α (TNF-α) and left ventricular ejection fraction (LVEF) of the three groups were compared at admission and 24 h after reperfusion.

Results The AUC of CK-MB in the combination group was significantly lower than that in the control group within 72 h (P < 0.05). The total number of premature ventricular beats and the number of ventricular tachycardia in the tVNS group and combined group were significantly lower than those in the control group within 24 h after reperfusion (P < 0.05). The levels of IL-6, HMGB1 and TNF-α in the combination group were significantly lower than those in the control group 24 h after reperfusion (P < 0.05). LVEF in the combination group was significantly higher than that in the light group at 7 days after reperfusion (P < 0.05).

Conclusion The tVNS significantly reducs the incidence of VAs after PCI in STEMI patients, but has little effect on the level of reperfusion inflammatory markers, myocardial infarction size, and acute left ventricular systolic function. The tVNS combined with RICP can produce significant benefits in the above indexes.