Real-World Major Adverse Cardiovascular Events of Nicorandil and Nitrate in Coronary Heart Disease in Central China:A Retrospective Cohort Study  

作　　者：Ping Li Juan Chen Na Li Xiang You Lan Shen Ning Zhou 

机构地区：[1]Department of Cardiothoracic Surgery,Union Hospital of Huazhong University of Science and Technology,Wuhan,Hubei 430022,China [2]Department of Cardiology,The Central Hospital of Wuhan,Huazhong University of Science and Technology,Wuhan,Hubei 430014,China [3]Division of Cardiology,Tongji Hospital of Huazhong University of Science and Technology,Wuhan,Hubei 430030,China [4]Chugai Pharma China Co.,Ltd.,Shanghai 200020,China [5]Department of Cardiology,Shanghai Chest Hospital,Shanghai Jiaotong University,Shanghai 200025,China.

出　　处：《Cardiology Discovery》2023年第3期152-158,共7页心血管病探索（英文）

摘　　要：Objective::Residual cardiovascular risk in patients with coronary heart disease(CHD)still needs to be addressed in real-world practice.This study aimed to examine the clinical effectiveness of nicorandil and nitrate in addition to optimal treatment for CHD patients.Methods::This retrospective cohort study included patients with CHD between October 2009 and March 2020 from 2 tertiary hospitals in Wuhan,China.Patients were grouped into nicorandil and nitrate groups depending on the first recorded antianginal therapy.Demographic and clinical data were collected from databases of the 2 hospitals.The primary outcome was cumulative 18-month major adverse cardiovascular event(MACE)-free survival,which was evaluated by Kaplan-Meier analysis.Propensity score matching(PSM)and multivariate Cox regression were adopted to adjust for confounding factors.Results::A total of 14,275 patients were analyzed,including 590 and 13,685 patients in the nicorandil and nitrate groups,respectively.With a median follow-up of 0.88(Q1,Q3:0.21,1.54)years,the cumulative 18-month MACE-free survival rates were comparable between the 2 groups(80.0%vs.75.0%,adjusted hazard ratio(aHR):1.04,95%confidence interval(CI):0.42-2.56,P=0.982,7)after 1:4 PSM.The cumulative 18-month stroke-free survival rate was significantly higher in the nicorandil group compared to the nitrate group(93.0%vs.84.0%,aHR:0.56,95%CI:0.34-0.92,P=0.023,5).Conclusion::This retrospective study showed that nicorandil and nitrate have similar 18-month rates of MACEs in CHD patients,but nicorandil is associated with lower incidence of stroke compared to nitrate.More studies need to be conducted to validate this association and explore the long-term benefit of nicorandil use on the occurrence of MACEs in the future.

关 键 词：Coronary disease Cardiovascular events NICORANDIL NITRATE 

分 类 号：R541.4[医药卫生—心血管疾病]