Oral Nicorandil to Reduce Cardiac Death After Coronary Revascularization in Hemodialysis Patients: A Randomized Trial

摘要: Background Survival after invasive coronary revascularization is worse in patients with chronic kidney disease than without disease. We examined whether oral administration of nicorandil, a hybrid nitrate and adenosine triphosphate–sensitive potassium channel opener, could improve outcome hemodialysis patients. Study Design Open-labeled prospective randomized trial. Setting & Participants Maintenance who underwent percutaneous artery intervention had complete (absence both restenosis de novo lesion) at arteriography 6 months later. Enrollment occurred between January 1, 2002, December 31, 2004. Interventions Treatment or 15 mg/d. Outcomes Measurements The primary end point was cardiac death (sudden from acute myocardial infarction congestive heart failure). secondary all-cause death. End-point adjudication performed masked to the intervention. Results 129 (91 men, 38 women) mean age 66 ± 9 (SD) years. During 2.7 1.5-year follow-up, 26 died events (acute infarction, 6; failure, 5; sudden death, 15), 12 noncardiac causes. Cardiac death–free survival rates were greater nicorandil group control ( P = 0.009; 3 years, 86.6% 70.7% group). All-cause also 0.01; 79.2% versus 60.5% Additional participants 2 group. No serious side effects reported during course study. Limitations Small sample size open-label design. Conclusions Oral may reduce revascularization.