Effectiveness of intraoperative nicorandil in patients with a history of ischemic heart disease undergoing high-risk noncardiac surgery: a retrospective cohort study

被引:2
作者
Miyake, Kentaro [1 ]
Yoshida, Satomi [1 ]
Seki, Tomotsugu [2 ]
Joo, Woo Jin [1 ]
Takeuchi, Masato [1 ]
Kawakami, Koji [1 ]
机构
[1] Kyoto Univ, Grad Sch Med & Publ Hlth, Dept Pharmacoepidemiol, Yoshidakonoe Cho,Sakyo Ku, Kyoto 6068501, Japan
[2] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Cardiovasc Med, Kyoto, Japan
关键词
Claims data; Cohort study; Major adverse cardiovascular events; Nicorandil; Noncardiac surgery; PERCUTANEOUS CORONARY INTERVENTION; MYOCARDIAL INJURY; CHANNEL OPENER; GLOBAL VOLUME; INFARCTION; EVENTS; IMPACT;
D O I
10.1007/s00540-023-03204-5
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
PurposeNicorandil is occasionally administered to prevent myocardial ischemia during the perioperative period in patients with ischemic heart disease (IHD); however, its effectiveness has not been clarified. In this study, we examined the effectiveness of intraoperative nicorandil administration in noncardiac surgery.MethodsWe identified patients with a history of IHD who had undergone high-risk noncardiac surgery between April 2015 and March 2020 from a nationwide in-patient database in Japan. The patients were divided into those who received nicorandil (nicorandil group) and those who did not (control group). The primary outcome was the 30-day in-hospital mortality. The secondary outcome was major adverse cardiovascular events (MACE), defined as the composite outcome of the 30-day in-hospital mortality, acute myocardial infarction, percutaneous coronary intervention, and coronary artery bypass grafting. One-to-one propensity score matching was performed. The outcomes were analyzed using a Cox proportional hazards model.ResultsOf 8037 patients, 2886 received nicorandil during surgery. After propensity score matching, 2554 pairs were analyzed. There was no significant difference in the 30-day in-hospital mortality (26 [1.02%] vs. 36 [1.41%]; hazard ratio [HR] 1.36; 95% confidence interval [CI] 0.82-2.26; P = 0.229) or incidence of MACE (42 [1.64%] vs. 55 [2.15%]; HR 1.24; 95% CI 0.86-1.93; P = 0.216) between the control and nicorandil groups.ConclusionThe findings of this study suggest that intraoperative nicorandil administration is not associated with the 30-day in-hospital mortality in high-risk noncardiac surgery.
引用
收藏
页码:562 / 572
页数:11
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