Abstract | PURPOSE: METHODS: This study was a subanalysis of our previous results that serial (123)I-MIBG scintigraphic studies are the most useful prognostic indicator in CHF patients. The study group comprised 208 patients with CHF (left ventricular ejection fraction <45 %) but no cardiac events for at least 5 months identified on the basis of a history of decompensated acute heart failure requiring hospitalization. These patients underwent (123)I-MIBG scintigraphy and echocardiography just before leaving the hospital and again 6 months later. We selected 170 patients and used propensity propensity score matching to compare patients who received oral nicorandil (85 patients) and those who did not (85 patients). The patients were followed up for a median of 5.03 years, with the primary and secondary study end-points defined as the occurrence of a fatal cardiac event and a major adverse cardiac event ( MACE), respectively. RESULTS:
After treatment, the extent of changes in (123)I-MIBG scintigraphic and echocardiographic parameters in the nicorandil group were more favourable than in those not receiving nicorandil. Of the 170 patients, a fatal cardiac event occurred in 42, and a MACE in 68 during the study. Multivariate Cox regression analyses revealed that no nicorandil treatment was a significant predictor of both cardiac death and MACE in our patients with CHF. On Kaplan-Meier analysis, the rates of freedom from cardiac death or from MACE in the nicorandil group were significantly higher than in those not receiving nicorandil (all p<0.05). CONCLUSION: Long-term nicorandil treatment improves CSNA and left ventricular parameters in patients with CHF. Furthermore, this agent is potentially effective for reducing the incidence of cardiac events in patients with CHF.
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Authors | Shu Kasama, Takuji Toyama, Toshiya Iwasaki, Hiroyuki Sumino, Hisao Kumakura, Kazutomo Minami, Shuichi Ichikawa, Naoya Matsumoto, Yuichi Sato, Masahiko Kurabayashi |
Journal | European journal of nuclear medicine and molecular imaging
(Eur J Nucl Med Mol Imaging)
Vol. 41
Issue 1
Pg. 144-54
(Jan 2014)
ISSN: 1619-7089 [Electronic] Germany |
PMID | 23982455
(Publication Type: Journal Article)
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Chemical References |
- Nicorandil
- 3-Iodobenzylguanidine
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Topics |
- 3-Iodobenzylguanidine
- Administration, Oral
- Adult
- Aged
- Aged, 80 and over
- Chronic Disease
- Death
- Electrocardiography
- Female
- Follow-Up Studies
- Heart Failure
(diagnostic imaging, drug therapy, pathology, physiopathology)
- Heart Ventricles
(drug effects, pathology)
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Multivariate Analysis
- Nicorandil
(administration & dosage, pharmacology, therapeutic use)
- Organ Size
(drug effects)
- Prognosis
- Radionuclide Imaging
- Sympathetic Nervous System
(drug effects, physiopathology)
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