Key result
Nicorandil treatment reduced all-cause mortality and hospitalization for cardiac causes (HR 0.35; P<0.001) and improved cardiac pump function in patients with heart failure.
Why the study?
Does nicorandil reduce mortality and hospitalization, and improve cardiac function in patients with heart failure?
Meta-Analysis (n=1,222)
Does nicorandil reduce mortality and hospitalization, and improve cardiac function in patients with heart failure?
Nicorandil demonstrates significant beneficial effects on mortality, cardiac hospitalizations, and cardiac pump function in patients with heart failure, suggesting its potential as an adjunctive therapy.
Supports adjunctive nicorandil in heart failure; reinforces Level 1 evidence for mortality and functional benefits.
BACKGROUND AND PURPOSE: It is unclear whether nicorandil, a metabolic therapeutic drug, can be applied clinically to therapy of heart failure (HF). This meta-analysis evaluated therapeutic effects of nicorandil on HF patients. EXPERIMENTAL APPROACH: We performed a systematic review and meta-analysis of published studies evaluating effect of nicorandil on HF patients. Studies were stratified according to controlled versus uncontrolled designs and analyzed using random-effects meta-analysis models. KEY RESULTS: We identified a total of 20 studies with a total of 1222 patients. In five randomized controlled studies, nicorandil treatment resulted in reduction in all-cause mortality and hospitalization for cardiac causes (HR: 0.35, P < 0.001) and improved cardiac pump function (SMD: 0.31, P = 0.02). In 15 observational studies, nicorandil therapy increases cardiac pump function (SMD: 0.75, P < 0.001), improves NYHA functional class (WMD: -1.33, P < 0.001), decreases PCWP (WMD: -6.86 mm Hg, P < 0.001), and pulmonary arterial pressure (SMD: -0.84, P < 0.001). CONCLUSIONS AND IMPLICATIONS: The use of nicorandil in HF patients exerts substantial beneficial effects, suggesting that it may be an additional therapeutic agent for HF.
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Zhao et al. (2014) conducted a meta-analysis in Heart failure (n=1,222). Nicorandil was evaluated on All-cause mortality and hospitalization for cardiac causes (HR 0.35, p=<0.001). Nicorandil treatment reduced all-cause mortality and hospitalization for cardiac causes (HR 0.35; P<0.001) and improved cardiac pump function in patients with heart failure.
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