TY - JOUR
T1 - Oral treatment with nicorandil at discharge is associated with reduced mortality after acute myocardial infarction
AU - Sakata, Yasuhiko
AU - Nakatani, Daisaku
AU - Shimizu, Masahiko
AU - Suna, Shinichiro
AU - Usami, Masaya
AU - Matsumoto, Sen
AU - Hara, Masahiko
AU - Sumitsuji, Satoru
AU - Kawano, Shigeo
AU - Iwakura, Katsuomi
AU - Hamasaki, Toshimitsu
AU - Sato, Hiroshi
AU - Nanto, Shinsuke
AU - Hori, Masatsugu
AU - Komuro, Issei
PY - 2012/1
Y1 - 2012/1
N2 - Background: Previous studies showed that nicorandil can reduce coronary events in patients with coronary artery disease. However, it is unclear whether oral nicorandil treatment may reduce mortality following acute myocardial infarction (AMI). Methods and Results: We examined the impact of oral nicorandil treatment on cardiovascular events in 1846 AMI patients who were hospitalized within 24. h after AMI onset, treated with emergency percutaneous coronary intervention (PCI), and discharged alive. Patients were divided into those with (Group N, n=535) and without (Group C, n= 1311) oral nicorandil treatment at discharge. No significant differences in age, gender, body mass index, prevalence of coronary risk factors, or history of myocardial infarction existed between the two groups; however, higher incidences of multi-vessel disease, and a lower rate of successful PCI were observed in Group N. During the median follow-up of 709 (340-1088) days, all-cause mortality rate was 43% lower in Group N compared with Group C (2.4% vs. 4.2%, stratified log-rank test: p= 0.0358). Multivariate Cox regression analysis revealed that nicorandil treatment was associated with all-cause death after discharge (Hazard ratio 0.495, 95% CI: 0.254-0.966, p=0.0393), but not for other cardiovascular events such as re-infarction, admission for heart failure, stroke and arrhythmia. Conclusions: The results suggest that oral administration of nicorandil is associated with reduced incidence of death in the setting of secondary prevention after AMI.
AB - Background: Previous studies showed that nicorandil can reduce coronary events in patients with coronary artery disease. However, it is unclear whether oral nicorandil treatment may reduce mortality following acute myocardial infarction (AMI). Methods and Results: We examined the impact of oral nicorandil treatment on cardiovascular events in 1846 AMI patients who were hospitalized within 24. h after AMI onset, treated with emergency percutaneous coronary intervention (PCI), and discharged alive. Patients were divided into those with (Group N, n=535) and without (Group C, n= 1311) oral nicorandil treatment at discharge. No significant differences in age, gender, body mass index, prevalence of coronary risk factors, or history of myocardial infarction existed between the two groups; however, higher incidences of multi-vessel disease, and a lower rate of successful PCI were observed in Group N. During the median follow-up of 709 (340-1088) days, all-cause mortality rate was 43% lower in Group N compared with Group C (2.4% vs. 4.2%, stratified log-rank test: p= 0.0358). Multivariate Cox regression analysis revealed that nicorandil treatment was associated with all-cause death after discharge (Hazard ratio 0.495, 95% CI: 0.254-0.966, p=0.0393), but not for other cardiovascular events such as re-infarction, admission for heart failure, stroke and arrhythmia. Conclusions: The results suggest that oral administration of nicorandil is associated with reduced incidence of death in the setting of secondary prevention after AMI.
KW - Acute myocardial infarction
KW - Mortality
KW - Nicorandil
KW - Secondary prevention
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U2 - 10.1016/j.jjcc.2011.08.001
DO - 10.1016/j.jjcc.2011.08.001
M3 - Article
C2 - 21924584
AN - SCOPUS:84855202767
VL - 59
SP - 14
EP - 21
JO - Journal of Cardiology
JF - Journal of Cardiology
SN - 0914-5087
IS - 1
ER -