title: Effects of nicorandil on cardiovascular events in patients with coronary artery disease in the Japanese Coronary Artery Disease (JCAD) study.
abstract: BACKGROUND
  Nicorandil has cardioprotective effects in the ischemic myocardium, mimicking ischemic preconditioning, and is thus expected to improve the prognosis of ischemic heart disease (IHD). As part of the Japanese Coronary Artery Disease (JCAD) Study, a multicenter collaborative prospective observational study of a large cohort of coronary artery disease patients, the effect of nicorandil on outcome was examined.
  
  
  RESULTS
  In total, 2,558 patients with nicorandil treatment and controls subjected to propensity score matching were eligible among 13,812 patients registered in the JCAD study. The mean follow-up interval was 2.7 years. The primary endpoint, death from all causes, was significantly lower, by 35% (hazard ratio 0.65, P=0.0008), in the nicorandil group than in the control group. There were also significant reductions in secondary endpoints, including cardiac death (56%), fatal myocardial infarction (56%), cerebral or vascular death (71%), and congestive heart failure (33%) in the nicorandil group, with no excess of deaths from other non-cardiovascular causes. Treatment with nicorandil reduced the number of deaths from all causes to a similar extent with or without treatment with sulfonylureas.
  
  
  CONCLUSIONS
  The reduction in cardiovascular death with nicorandil was large in patients with IHD, which has important implications for treatment.
authors.affiliation: Department of Hypertension and Cardiorenal Medicine, Dokkyo Medical University, Tochigi, Japan. horinaka@dokkyomed.ac.jp
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horinaka
authors.forename: Akihisa
authors.initials: A
authors.lastname: Yabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishimitsu
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Shinya
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takahide
authors.initials: T
authors.lastname: Kohro
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000401:mortality*; D020108:Nicorandil / Q000627:therapeutic use*; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D020108:Nicorandil