title: Effects of intravenous nicorandil on the mid-term prognosis of patients with acute heart failure syndrome.
abstract: BACKGROUND
  Acute heart failure syndrome (AHFS) remains a major clinical challenge because of its poor prognosis. Nicorandil, a hybrid compound of a potassium-channel opener and nitric oxide donor, has been reported to improve the prognosis of ischemic heart disease. We sought to evaluate the effect of intravenous nicorandil on the mid-term prognosis of AHFS.
  
  
  RESULTS
  A total of 402 consecutive patients who were hospitalized for AHFS were divided into 2 groups according to the use of intravenous nicorandil: 78 patients in the Nicorandil group and 324 patients in the Control group. During the 180-day follow-up, death or rehospitalization for heart failure occurred in 7 patients in the Nicorandil group (9.0%) and in 75 patients (23.2%) in the Control group. Event-free survival rates were significantly higher in the Nicorandil group than in the Control group (P=0.006). Multivariate Cox hazard analysis revealed that age (hazard ratio (HR)=1.066, P<0.0001), systolic blood pressure (HR=0.983, P=0.0023), New York Heart Association class III/IV (HR=6.550, P<0.0001), log creatinine (HR=3.866, P=0.0106), and use of intravenous nicorandil (HR=0.179, P<0.0001) were significant predictive factors for the occurrence of death or rehospitalization for heart failure.
  
  
  CONCLUSIONS
  Intravenous nicorandil treatment from the urgent phase of AHFS may improve the prognosis.
authors.affiliation: Department of Cardiology, Steel Memorial Yawata Hospital, 1-1-1 Harunomachi, Yahatahigashi-ku, Kitakyushu 805-0050, Japan. ishihara.s@ns.yawata-mhp.or.jp
authors.forename: Shiro
authors.initials: S
authors.lastname: Ishihara
authors.forename: Tokushi
authors.initials: T
authors.lastname: Koga
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kaseda
authors.forename: Eiji
authors.initials: E
authors.lastname: Nyuta
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Haga
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Fujishima
authors.forename: Takao
authors.initials: T
authors.lastname: Ishitsuka
authors.forename: Seizo
authors.initials: S
authors.lastname: Sadoshima
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D020108:Nicorandil / Q000008:administration & dosage*; D012189:Retrospective Studies; D015996:Survival Rate; D013577:Syndrome
chemical_list: D000889:Anti-Arrhythmia Agents; D020108:Nicorandil