Clinical potential of nicorandil to inhibit major cardiac events in hemodialysis patients with suspected myocardial ischemia.

Abstract

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.

• Authors: Masato Nishimura, Toshiko Tokoro, Masaya Nishida, Tetsuya Hashimoto, Hiroyuki Kobayashi, Satoru Yamazaki, Ryo Imai, Koji Okino, Noriyuki Iwamoto, Hakuo Takahashi, Toshihiko Ono
• Journal: Nephron. Clinical practice (Nephron Clin Pract) Vol. 111 Issue 3 Pg. c212-21 ( 2009) ISSN: 1660-2110 [Electronic] Switzerland
• PMID: 19225237 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Nicorandil

Topics

• Aged
• Death
• Female
• Follow-Up Studies
• Humans
• Kidney Diseases (complications, drug therapy, mortality)
• Male
• Middle Aged
• Myocardial Ischemia (complications, mortality, prevention & control)
• Nicorandil (therapeutic use)
• Renal Dialysis (adverse effects, mortality)