SY4-1 - Beneficial Impact of Nicorandil on Mortality in Patients With Ischemic Heart Failure

Abstract

Background: Effective treatments in heart failure (HF) patients with ischemic etiology have not been fully established. Nicorandil, combination of nitrate component and sarcolemmal ATP-sensitive potassium channel opener, is a potent vasodilator of coronary and peripheral vessels and has been used as an antianginal agent. Therefore, we examined impacts of nicorandil on mortality in ischemic HF patients. Methods and Results: We analyzed 334 HF patients with ischemic etiology. These patients were divided into 2 groups: nicorandil group (n = 116) and non-nicorandil group (n = 218). Baseline characteristics including age, gender, NYHA class, left ventricular ejection fraction, B-type natriuretic peptide, estimated glomerular filtration rate, presence of hypertension, diabetes, dyslipidemia, atrial fibrillation, chronic kidney disease, anemia and smoking did not differ between the two groups. In the Kaplan-Meier analysis (mean follow-up period 963 days), all-cause mortality was significantly lower in the nicorandil group than in the non-nicorandil group (24.1% vs. 35.8%, P = .018). In the Cox proportional hazard analysis after adjusting for potential confounding factors, use of nicorandil was an independent predictor of mortality in HF patients with ischemic etiology (hazard ratio 0.618, 95% confidence interval 0.400–0.953, P = .030). Conclusion: Nicorandil is potentially effective for reducing mortality in patients with ischemic heart failure.