Document Detail


Nicorandil treatment in patients with acute myocardial infarction: a meta-analysis.
MedLine Citation:
PMID:  19325192     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is controversial as to whether nicorandil would have cardioprotective effects in patients with acute myocardial infarction (AMI) who are undergoing reperfusion therapy. A meta-analysis was performed to study the impacts of nicorandil on functional outcomes after AMI. METHODS AND RESULTS: Randomized prospective cohort or retrospective cohort publications were identified up to October 2007 by means of a computer search of MEDLINE and Google Scholar databases. Two reviewers checked the quality of the studies and extracted data regarding patient and disease characteristics, study design, functional parameters such as Thrombolysis In Myocardial Infarction (TIMI) flow grade after reperfusion, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume index (LVEDVI). Seventeen studies were included for the meta-analysis in this study. Nicorandil treatment reduced the incidence of TIMI flow grade < or =2 in 1,337 patients of 10 studies (risk ratio 0.63; 95% confidence interval (CI) 0.44 to 0.91). While no beneficial effect was observed on the peak creatine kinase value, nicorandil treatment was associated with greater LVEF (by 3.7%, 95%CI 1.8 to 5.7%), and lower LVEDVI (by 8.8 ml/kg, -14.4 to -3.3 ml/kg) in 905 patients of 11 studies. CONCLUSIONS: The meta-analysis demonstrated that nicorandil treatment adjunctive to reperfusion therapy has beneficial effects on microvascular function and on functional recovery after AMI.
Authors:
Katsuomi Iwakura; Hiroshi Ito; Atsushi Okamura; Yasushi Koyama; Motoo Date; Yoshiharu Higuchi; Koichi Inoue; Ryusuke Kimura; Hiroyuki Nagai; Michio Imai; Yuko Toyoshima; Makito Ozawa; Norihisa Ito; Yukinori Okazaki; Masahiko Shibuya; Hideaki Suenaga; Asuka Kubota; Kenshi Fujii
Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2009-03-27
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  73     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  925-31     Citation Subset:  IM    
Affiliation:
Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan. iwakura@mac.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiovascular Agents / adverse effects,  therapeutic use*
Combined Modality Therapy
Coronary Circulation / drug effects
Female
Humans
Male
Microcirculation / drug effects
Middle Aged
Myocardial Infarction / drug therapy,  physiopathology,  therapy*
Myocardial Reperfusion* / adverse effects
Nicorandil / adverse effects,  therapeutic use*
No-Reflow Phenomenon / etiology,  physiopathology,  prevention & control*
Publication Bias
Recovery of Function
Stroke Volume / drug effects
Treatment Outcome
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 65141-46-0/Nicorandil

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