Oral treatment with nicorandil at discharge is associated with reduced mortality after acute myocardial infarction

被引：28

作者：

Sakata, Yasuhiko ^{[1
]}

Nakatani, Daisaku ^{[1
]}

Shimizu, Masahiko ^{[1
]}

Suna, Shinichiro ^{[1
]}

Usami, Masaya ^{[1
]}

Matsumoto, Sen ^{[1
]}

Hara, Masahiko ^{[1
]}

Sumitsuji, Satoru ^{[1
,2
]}

Kawano, Shigeo ^{[3
]}

Iwakura, Katsuomi ^{[4
]}

Hamasaki, Toshimitsu ^{[5
]}

Sato, Hiroshi ^{[6
]}

Nanto, Shinsuke ^{[1
,2
]}

Hori, Masatsugu ^{[7
]}

Komuro, Issei ^{[1
]}

机构：

[1] Osaka Univ, Grad Sch Med, Dept Cardiovasc Med, Suita, Osaka 5650871, Japan

[2] Osaka Univ, Grad Sch Med, Dept Adv Cardiovasc Therapeut, Suita, Osaka 5650871, Japan

[3] Kawachi Gen Hosp, Div Cardiovasc, Higashiosaka, Osaka, Japan

[4] Sakurabashi Watanabe Hosp, Div Cardiol, Osaka, Japan

[5] Osaka Univ, Grad Sch Med, Dept Biomed Stat, Suita, Osaka 5650871, Japan

[6] Kwansei Gakuin Univ, Sch Human Welf Studies, Hlth Care Ctr & Clin, Nishinomiya, Osaka, Japan

[7] Osaka Med Ctr Canc & Cardiovasc Dis, Osaka, Japan

来源：

JOURNAL OF CARDIOLOGY | 2012年 / 59卷 / 01期

关键词：

Nicorandil; Acute myocardial infarction; Mortality; Secondary prevention; SYMPATHETIC-NERVE ACTIVITY; POTASSIUM CHANNEL OPENERS; INTRAVENOUS NICORANDIL; REPERFUSION THERAPY; INTRACORONARY THROMBECTOMY; CORONARY ANGIOPLASTY; 30-DAY MORTALITY; IMPACT; ARTERY; INJURY;

D O I：

10.1016/j.jjcc.2011.08.001

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

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 24h 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% Cl: 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. (C) 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

引用

页码：14 / 21

页数：8

共 36 条

[1]

The relationships of left ventricular ejection fraction, end-systolic volume index and infarct size to six-month mortality after hospital discharge following myocardial infarction treated by thrombolysis [J].