Abstract | BACKGROUND: OBJECTIVE: METHODS: For this retrospective chart review, we used data from telephone interviews and medical charts from 3 hospitals in Japan. Data from patients aged <80 years who were receiving hemodialysis for ESRD and who had undergone successful PCI for angina between January 1999 and December 2004 were included in the analysis. Patients were stratified based on status of nicorandil treatment before PCI, as follows: patients receiving nicorandil 5 mg PO TID (the recommended dosage in Japan) for >1 month before PCI ( nicorandil group) or those who did not receive nicorandil (control group). We investigated 6-year follow-up data on the primary end point, defined as CVEs (ie, unplanned hospital admission for worsening anginal status, or CVE-related death). The secondary end point was CVE-related death. After the data were initially analyzed, we performed a propensity-matched analysis to minimize selection bias. RESULTS: Data from 356 patients were included in the study (235 men, 121 women; mean [SD] age, 69 [9] years; mean [SD] weight, 52.3 [9.1] kg; nicorandil group, 198 patients; control group, 158 patients). According to the estimated propensity scores, 107 patients from each group were matched. There were no differences between the 2 groups in the baseline characteristics. On propensity-matched patient analysis, the estimated rates of patients who were CVE-free at 6 years were 33.5% in the nicorandil group and 21.8% in the control group on Kaplan-Meier analysis (hazard ratio [HR] = 0.53; 95% CI, 0.36-0.78; P < 0.002), and the rates of 6-year survival (ie, patients who did not experience CVE-related death) were 92.7% in the nicorandil group and 85.8% in the control group (HR = 0.27; 95% CI, 0.07-0.89; P = 0.047). Cox multivariate analysis found that nico-randil treatment status was an independent predictor of CVEs (HR = 0.40; 95% CI, 0.18-0.91; P = 0.028) and CVE-related death (HR = 0.38; 95% CI, 0.14-0.78; P = 0.030). CONCLUSION: Results obtained in this retrospective study suggest the potential efficacy of nicorandil treatment in improving clinical outcomes in patients with IHD receiving hemodialysis following PCI.
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Authors | Hideki Ishii, Takanobu Toriyama, Toru Aoyama, Hiroshi Takahashi, Shigeki Yamada, Hirotake Kasuga, Satoshi Ichimiya, Masaaki Kanashiro, Hirotsugu Mitsuhashi, Shoichi Maruyama, Seiichi Matsuo, Keiko Naruse, Tatsuaki Matsubara, Toyoaki Murohara |
Journal | Clinical therapeutics
(Clin Ther)
Vol. 29
Issue 1
Pg. 110-22
(Jan 2007)
ISSN: 0149-2918 [Print] United States |
PMID | 17379051
(Publication Type: Journal Article)
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Chemical References |
- Vasodilator Agents
- Nicorandil
|
Topics |
- Administration, Oral
- Aged
- Angina Pectoris
(complications, therapy)
- Angioplasty, Balloon, Coronary
- Female
- Humans
- Japan
- Kidney Failure, Chronic
(complications, therapy)
- Male
- Middle Aged
- Multivariate Analysis
- Myocardial Ischemia
(etiology, prevention & control)
- Nicorandil
(therapeutic use)
- Prognosis
- Renal Dialysis
(adverse effects)
- Retrospective Studies
- Risk Factors
- Survival Rate
- Treatment Outcome
- Vasodilator Agents
(therapeutic use)
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