title: Improvement of myocardial fatty acid metabolism by oral nicorandil in hemodialysis patients without coronary artery disease.
abstract: BACKGROUND
  We investigated the potential of oral nicorandil to improve myocardial fatty acid metabolism assessed by single-photon emission computed tomography (SPECT) using (123)I-β-methyliodophenyl pentadecanoic acid (BMIPP) in hemodialysis patients without obstructive coronary artery disease (CAD).
  
  
  METHODS
  This study was based on a cohort study of 155 hemodialysis patients with angiographic absence of obstructive CAD, with analysis performed in 100 propensity-matched patients (54 men and 46 women, 64 ± 10 years); 50 with oral administration of nicorandil (15 mg/d, nicorandil group) and 50 without (control). BMIPP SPECT was performed every year after angiography. Uptake on SPECT was graded in 17 segments on a five-point scale (0 normal, 4 absent) and assessed as BMIPP summed scores (SS).
  
  
  RESULTS
  Over a mean follow-up period of 5.3 ± 1.9 years, we observed 25 cardiac deaths among 100 propensity-matched patients. Myocardial uptake of BMIPP in SPECT improved in the nicorandil group compared with the control group from 2 years of administration. In Kaplan-Meier survival analyses, free survival rate from cardiac death was higher in patients with a BMIPP SS improvement rate of ≥20% compared to those with ≥0% <20% or with <0% BMIPP SS improvement rate. At multiple logistic analysis, a ≥20% BMIPP SS improvement rate was positively associated with serum albumin concentration and oral nicorandil.
  
  
  CONCLUSIONS
  Long-term oral nicorandil may inhibit cardiac death by improving myocardial fatty acid metabolism in hemodialysis patients without obstructive CAD.
authors: Cardiovascular Division, Toujinkai Hospital, 83-1, Iga, Momoyama-cho, Fushimi-ku, Kyoto, 612-8026, Japan, mnishimura@tea.ocn.ne.jp.
authors: Masato
authors: M
authors: Nishimura
authors: Yu
authors: Y
authors: Okamoto
authors: Toru
authors: T
authors: Takatani
authors: Nodoka
authors: N
authors: Sato
authors: Masaya
authors: M
authors: Nishida
authors: Tetsuya
authors: T
authors: Hashimoto
authors: Satoru
authors: S
authors: Yamazaki
authors: Hiroyuki
authors: H
authors: Kobayashi
authors: Toshihiko
authors: T
authors: Ono
mesh_terms: D000284:Administration, Oral; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D003324:Coronary Artery Disease / Q000150:complications; D018572:Disease-Free Survival; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D020108:Nicorandil / Q000008:administration & dosage / Q000494:pharmacology*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy; D012709:Serum Albumin / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D005227:Fatty Acids; D007462:Iodobenzenes; D012709:Serum Albumin; D014665:Vasodilator Agents; C049338:iodofiltic acid; D020108:Nicorandil