Nicorandil decreases cardiac events during and after noncardiac surgery

Study ObjectiveTo assess whether nicorandil reduces the likelihood of cardiac events during and after intermediate risk surgery.DesignMulticenter study.Setting13 hospitals in Japan.PatientsIntermediate-risk patients were identified by the presence of risk factors such as angina, a history of myocardial infarction, heart failure, diabetes mellitus, and abnormal electrocardiography (ECG).InterventionsNicorandil was given to these patients during the operation.Measurements and Main ResultsCardiac events during the operation and the following 5 days were monitored. The frequency of cardiac events in nicorandil-treated patients was compared with those in nontreated patients. Eighty-four patients received nicorandil during surgery and 237 patients received standard care. Cardiac events in the nicorandil-treated group occurred less frequently both during the operation (odds ratio, 0.15; 95% confidence interval, 0.03-0.76; P = 0.02) and after it (odds ratio, 0.24; 95% confidence interval, 0.06-0.90; P = 0.04).ConclusionsNicorandil reduces the frequency of cardiac events in patients undergoing noncardiac surgery, both during and after the operation.