Nicorandil decreases cardiac events during and after noncardiac surgery.
OBJECTIVE
To assess whether nicorandil reduces the likelihood of cardiac events during and after intermediate risk surgery.


METHODS
Multicenter study.


METHODS
13 hospitals in Japan.


METHODS
Intermediate-risk patients were identified by the presence of risk factors such as angina, a history of myocardial infarction, heart failure, diabetes mellitus, and abnormal electrocardiography (ECG).


METHODS
Nicorandil was given to these patients during the operation.


RESULTS
Cardiac events during the operation and the following 5 days were monitored. The frequency of cardiac events in nicorandil-treated patients was compared with those in nontreated patients. Eighty-four patients received nicorandil during surgery and 237 patients received standard care. Cardiac events in the nicorandil-treated group occurred less frequently both during the operation (odds ratio, 0.15; 95% confidence interval, 0.03-0.76; P=0.02) and after it (odds ratio, 0.24; 95% confidence interval, 0.06-0.90; P=0.04).


CONCLUSIONS
Nicorandil reduces the frequency of cardiac events in patients undergoing noncardiac surgery, both during and after the operation.
Kashimoto
Satoshi
S
Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, Tamaho, Yamanashi 409-3898, and Department of Anesthesia, Cancer Institute Hospital, Tokyo, Japan. satoshik@yamanashi.ac.jp
Seki
Makoto
M
Ishiguro
Toshihiko
T
Yoshioka
Hitoshi
H
Nagata
Osamu
O
Nishimura
Kinya
K
Kikuchi
Toshihiro
T
Yamada
Tatsuya
T
Iwade
Motoyo
M
Omi
Akibumi
A
Honda
Osamu
O
Sakamoto
Atsuhiro
A
Ogihara
Yukihiko
Y
Fujimoto
Keiko
K
Nakaigawa
Yasushi
Y
Kato
Jitsu
J
Watanabe
Akio
A
Nomura
Minoru
M
Takeda
Junzo
J
D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D007564:Japan; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D020108:Nicorandil