All-cause mortality and cardiovascular events with nicorandil in patients with IHD: Systematic review and meta-analysis of the literature

- Nicorandil as an adjunct to IHD is associated with reduced cardiovascular events.
- Nicorandil might be a promising therapeutic medicine in cardioprotection.
- Nicorandil might be benefit for hemodialysis or diabetes patients with IHD.
- Our meta-analysis use the rigorous methodological approach.

BackgroundNicorandil is able to protect the cardiomyocytes from ischemic damage, but clear benefits of nicorandil in all-cause mortality and cardiovascular events were not consistently reported in patients with ischemic heart disease (IHD).Materials and resultsCochrane, PubMed, EMBASE, CBM, CNKI and Wangfang databases were searched for randomized controlled trials. Data on all-cause mortality and cardiovascular events were collected. Nicorandil groups were pooled to perform a comparison with control groups and to get the pooled odds ratios (ORs) and associated 95% confidence intervals (CIs) for all-cause mortality, relative risks (RRs), and associated 95% CIs for cardiovascular events. STATA 11.0 software was used for all-cause mortality and cardiovascular events statistics. We retrieved 17 randomized controlled studies enrolling a total of 7305 patients. The addition of nicorandil treatment significantly reduced cardiovascular events (13.83% versus 18.01%; RR, 0.77; 95% CI, 0.69 to 0.86). No differences in all-cause mortality (3.83% versus 4.70%; OR, 0.81; 95% CI, 0.64 to 1.02), and repeat revascularization rate (13.06% versus 13.54%; RR, 0.95; 95% CI, 0.70 to 1.29) were observed. There was a weak linear association between cardiovascular events and nicorandil in IHD with diabetes (P = 0.099).ConclusionsThe results suggest that nicorandil as an adjunct therapy to IHD is associated with reduced cardiovascular events in patients with IHD.