Long-term Effects of Nicorandil Combined with Dihydropyridine Calcium Channel Blockers on Cardiovascular Outcomes in Patients with Coronary Heart Disease: A Real-world Observational Study  

作　　者：Jia Cheng Zixuan Zhang Hongyang Shu Weijian Hang Qingqing Zhao Jinzhao Zhao Zhichao Xiao Ning Zhou 

机构地区：[1]Division of Cardiology,Tongji hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China

出　　处：《Cardiovascular Innovations and Applications》2023年第1期633-644,共12页心血管创新与应用(英文)

摘　　要：Objective:This study was aimed at investigating whether the addition of nicorandil to a dihydropyridine calcium channel blocker(DHP-CCB)regimen might decrease the occurrence of major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD).Methods:A multicenter,retrospective,real-world study was conducted.Between August 2002 and March 2020,7413 eligible patients with CHD were divided into DHP-CCB plus nicorandil combination(n=1843)and DHP-CCB(n=5570)treatment groups.The primary outcome was MACE,defined as a composite of myocardial infarction,stroke,and all-cause mortality.Propensity score matching was used to adjust for confounding factors.Results:After propensity score matching,combination therapy,compared with DHP-CCBs alone,was associated with a lower risk of MACE(HR:0.80,95%CI:0.67–0.97).The combination group also had a lower risk of stroke(HR:0.55,95%CI:0.44–0.69),but not myocardial infarction(HR:1.21,95%CI:0.91–1.61)or all-cause mortality(HR:1.24,95%CI:0.63–2.44).Subgroup analysis revealed more prominent benefits of the combined treatment on MACE in patients with than without diabetes.Conclusions:The combination of nicorandil and DHP-CCBs may be more beneficial than DHP-CCBs alone in decreasing long-term risks of MACE and stroke in patients with CHD.

关 键 词：coronary heart disease ANGINA NICORANDIL calcium channel blockers major adverse cardiovascular events 

分 类 号：R541.4[医药卫生—心血管疾病]