title: Oral nicorandil for prevention of cardiac death in hemodialysis patients without obstructive coronary artery disease: a propensity-matched patient analysis.
abstract: OBJECTIVE
  We examined the potential of oral administration of nicorandil for protecting against cardiac death in hemodialysis patients without obstructive coronary artery disease.
  
  
  METHODS
  This study was based on a cohort study of 155 hemodialysis patients with angiographic absence of obstructive coronary lesions, with analysis performed in 100 propensity-matched patients (54 men and 46 women, 64 ± 10 years), including 50 who received oral administration of nicorandil (15 mg/day, nicorandil group) and 50 who did not (control). The efficacy of nicorandil in preventing cardiac death was investigated.
  
  
  RESULTS
  Over a mean follow-up period of 5.3 ± 1.9 years, we observed 25 cardiac deaths among 100 propensity-matched patients, including 6 due to acute myocardial infarction, 11 due to heart failure, and 8 due to sudden cardiac death. The incidence of cardiac death was lower (p < 0.001) in the nicorandil group (4/50, 8%) than in the control (21/50, 42%). On multivariate Cox hazard analysis, cardiac death was inversely associated with oral nicorandil (hazard ratio, 0.123; p = 0.0002). On Kaplan-Meier analysis, cardiac death-free survival rates at 5 years were higher in the nicorandil group than in the control group (91.4 vs. 66.4%).
  
  
  CONCLUSIONS
  Oral nicorandil may inhibit cardiac death of hemodialysis patients without obstructive coronary artery disease.
authors.affiliation: Cardiovascular Division, Toujinkai Hospital, Kansai Medical University, Osaka, Japan. mnishimura@tea.ocn.ne.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Nishimura
authors.forename: Chikako
authors.initials: C
authors.lastname: Sakoda
authors.forename: Mayuko
authors.initials: M
authors.lastname: Murakawa
authors.forename: Yu
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Toshiko
authors.initials: T
authors.lastname: Tokoro
authors.forename: Nodoka
authors.initials: N
authors.lastname: Sato
authors.forename: Masaya
authors.initials: M
authors.lastname: Nishida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Iwamoto
authors.forename: Hakuo
authors.initials: H
authors.lastname: Takahashi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ono
mesh_terms: D000284:Administration, Oral; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017023:Coronary Angiography; D003327:Coronary Disease; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D007333:Insulin Resistance; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D020108:Nicorandil / Q000008:administration & dosage / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D002317:Cardiovascular Agents; D020108:Nicorandil