Document Detail

Clinical potential of nicorandil to inhibit major cardiac events in hemodialysis patients with suspected myocardial ischemia.
MedLine Citation:
PMID:  19225237     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: We examined whether nicorandil, which is a hybrid of an adenosine triphosphate-sensitive potassium channel opener and a nitrate, could inhibit major adverse cardiac events (MACE) in maintenance hemodialysis patients with suspected myocardial ischemia. METHODS: We enrolled 148 asymptomatic patients on maintenance hemodialysis, who had exhibited potential myocardial ischemia as assessed by myocardial fatty acid imaging. The end-point was MACE including cardiac death and non-fatal acute myocardial infarction. A propensity-matched analysis was performed. RESULTS: Over a mean duration of follow-up of 2.8 +/- 1.6 years in the 82 propensity-matched patients (41 in the nicorandil group and 41 in the non-nicorandil group), we observed 17 cardiac deaths and 12 cases of nonfatal myocardial infarction. The incidence of MACE was lower (p = 0.0365) in the nicorandil group (10/41, 24.4%) than in the non-nicorandil group (19/41, 46.3%). On stepwise Cox hazard analysis, MACE was significantly inhibited by administration of nicorandil (hazard risk, 0.387; 95% CI 0.178-0.842; p = 0.0168). Kaplan-Meier survival estimates revealed that MACE-free survival rates at 3 years were 80.5 and 58.5% in patients with and without nicorandil, respectively. CONCLUSIONS: Oral administration of nicorandil may offer new potential for the inhibition of MACE in hemodialysis patients.
Masato Nishimura; Toshiko Tokoro; Masaya Nishida; Tetsuya Hashimoto; Hiroyuki Kobayashi; Satoru Yamazaki; Ryo Imai; Koji Okino; Noriyuki Iwamoto; Hakuo Takahashi; Toshihiko Ono
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-02-19
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  111     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2009  
Date Detail:
Created Date:  2009-03-26     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c212-21     Citation Subset:  IM    
Cardiovascular Division, Toujinkai Hospital, Fushimi-ku, Kyoto, Japan.
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MeSH Terms
Follow-Up Studies
Kidney Diseases / complications,  drug therapy,  mortality
Middle Aged
Myocardial Ischemia / complications,  mortality,  prevention & control*
Nicorandil / therapeutic use*
Renal Dialysis / adverse effects*,  mortality
Reg. No./Substance:

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