Objective: To investigate the effects of ivabredine combined with niccordil on myocardial function and vascular endothelial function in patients undergoing percutaneous coronary intervention for acute myocardial infarction.Methods: This retrospective study included 80 acute myocardial infarction patients treated with percutaneous coronary intervention (PCI) between May 2023 and May 2025. Using a matched-group design, patients were evenly divided into two groups based on medication regimens. The control group (n=40) received nicorandil, while the observation group (n=40) was treated with ivabradine in combination. Comparative analyses were conducted on cardiac function parameters, vascular endothelial function indices, and quality of life, along with statistical evaluation of adverse drug reactions in both groups.Results: Compared with pre-treatment levels, both groups showed improvements in left ventricular ejection fraction, cardiac index, cardiac output, stroke volume, nitric oxide, superoxide dismutase, and quality of life scores (P <0.05). Erythrocyte-derived endothelin-1 and malondialdehyde levels decreased significantly (P <0.05), with more pronounced improvements observed in the treatment group (P <0.05). No significant difference in adverse reaction rates was found between groups (P> 0.05). Conclusion: The combination therapy of ivabredine and niccoldil for acute myocardial infarction following percutaneous coronary intervention (PCI) improves cardiac function, regulates vascular endothelial function, enhances quality of life, and demonstrates preventive efficacy against adverse reactions.