Improvement of myocardial fatty acid metabolism by oral nicorandil in hemodialysis patients without coronary artery disease.

Abstract

BACKGROUND:

We investigated the potential of oral nicorandil to improve myocardial fatty acid metabolism assessed by single-photon emission computed tomography (SPECT) using (123)I-β-methyliodophenyl pentadecanoic acid (BMIPP) in hemodialysis patients without obstructive coronary artery disease (CAD).

METHODS:

This study was based on a cohort study of 155 hemodialysis patients with angiographic absence of obstructive CAD, with analysis performed in 100 propensity-matched patients (54 men and 46 women, 64 ± 10 years); 50 with oral administration of nicorandil (15 mg/d, nicorandil group) and 50 without (control). BMIPP SPECT was performed every year after angiography. Uptake on SPECT was graded in 17 segments on a five-point scale (0 normal, 4 absent) and assessed as BMIPP summed scores (SS).

RESULTS:

Over a mean follow-up period of 5.3 ± 1.9 years, we observed 25 cardiac deaths among 100 propensity-matched patients. Myocardial uptake of BMIPP in SPECT improved in the nicorandil group compared with the control group from 2 years of administration. In Kaplan-Meier survival analyses, free survival rate from cardiac death was higher in patients with a BMIPP SS improvement rate of ≥20% compared to those with ≥0% <20% or with <0% BMIPP SS improvement rate. At multiple logistic analysis, a ≥20% BMIPP SS improvement rate was positively associated with serum albumin concentration and oral nicorandil.

CONCLUSIONS:

Long-term oral nicorandil may inhibit cardiac death by improving myocardial fatty acid metabolism in hemodialysis patients without obstructive CAD.

• Authors: Masato Nishimura, Yu Okamoto, Toru Takatani, Nodoka Sato, Masaya Nishida, Tetsuya Hashimoto, Satoru Yamazaki, Hiroyuki Kobayashi, Toshihiko Ono
• Journal: Journal of nephrology (J Nephrol) Vol. 28 Issue 2 Pg. 227-34 (Apr 2015) ISSN: 1724-6059 [Electronic] Italy
• PMID: 25070153 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Fatty Acids
• Iodobenzenes
• Serum Albumin
• Vasodilator Agents
• iodofiltic acid
• Nicorandil

Topics

• Administration, Oral
• Aged
• Cardiovascular Diseases (mortality)
• Coronary Artery Disease (complications)
• Disease-Free Survival
• Fatty Acids (metabolism)
• Female
• Heart (drug effects)
• Humans
• Iodobenzenes
• Male
• Middle Aged
• Myocardium (metabolism)
• Nicorandil (administration & dosage, pharmacology)
• Renal Dialysis
• Renal Insufficiency, Chronic (complications, therapy)
• Serum Albumin (metabolism)
• Tomography, Emission-Computed, Single-Photon
• Vasodilator Agents (administration & dosage, pharmacology)