Abstract 14641: Effect of Nicorandil on Clinical Outcomes in Patient With Acute Myocardial Infarction
Nicorandil has cardiac protective effect in the ischemic myocardium, which is related to ischemic preconditioning, prevent vasospasm, myocardial necrosis, and improve coronary artery perfusion.
We assessed the hypothesis that nicorandil could be beneficial effect on patients with acute myocardial infarction.
Total 6370 patients with ST segment elevation myocardial infarction (STEMI) in Korean Acute Myocardial Infarction Registry (KAMIR) were divided to two group: a group treated with nicorandil(STEMI-N group, n=1,313) and a group treated without nicorandil(STEMI-C group, n= 5,057,). 4184 patients with non-ST segment elevation myocardial infarction (NSTEMI) in KAMIR were divided to two groups: a group treated with nicorandil (NSTEMI-N group, n=874) and a group treated without nicorandil (NSTEMI-C group, n= 3,306). We analyzed for death and myocardial infarction and composite of major adverse cardiac events (MACE) at 1, 6 month.
As a result, STEMI-N group is significant low incidence of MACE, MI compared to STEMI-C group at 1 month(Composite MACE: 2.2% vs. 4.1%, p=0.001, MI: 0.1% vs. 0.5%, p=0.019). At 6 month, STEMI-N group is also significant low incidence of MACE, MI compared to STEMI-C group. (Composite MACE: 8.1% vs. 10.1%, p=0.047, MI: 0.1% vs. 0.9% p=0.002). Patients with NSTEMI do not show differences of clinical outcomes at 1, 6 months between NSTEMI-N group and NSTEMI-C group.
In conclusion, the reductions observed in MACE and MI with nicorandil in the KAMIR data were large, given the short period of follow-up, in patients with STEMI, which has important implications for their treatment. But, there was no beneficial effect of nicorandil in patients with NSTEMI.
- © 2013 by American Heart Association, Inc.