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Combination of Nicorandil and Beta-Adrenergic Receptor Blockers in Patients with Coronary Artery Disease: A

Jia Cheng1,2, Lin Qiu3, Zixuan Zhang1,2

  • 1Division of Cardiology, Department of Internal Medicine, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

Journal of Cardiovascular Pharmacology and Therapeutics
|September 4, 2023
PubMed

Insights

Combining nicorandil with beta-adrenergic receptor blockers (BBs) significantly reduced major adverse cardiovascular events (MACE) and stroke in coronary artery disease (CAD) patients. This combination therapy may offer improved long-term outcomes compared to BBs alone.

Area of Science:

  • Cardiology
  • Clinical Pharmacology

Background:

  • Long-term clinical outcomes of combined nicorandil and beta-adrenergic receptor blockers (BBs) versus BBs alone in coronary artery disease (CAD) patients are not well-defined.
  • Coronary artery disease (CAD) management often involves addressing angina and preventing major adverse cardiovascular events (MACE).

Purpose of the Study:

  • To evaluate the long-term efficacy of combined nicorandil and BBs compared to BBs alone in patients with CAD.
  • To assess the impact of this combined therapy on the incidence of MACE and its components.

Main Methods:

  • A multicenter retrospective cohort study involving 16,912 adult CAD patients treated for angina.
  • Analysis of cumulative incidence of MACE and components over 2.5 years using Kaplan-Meier curves.
  • Inverse probability of treatment weighting (IPTW) applied to adjust for confounding factors.

Main Results:

  • Combined nicorandil and BBs treatment was associated with a significantly reduced incidence of MACE (HR 0.79, 95% CI 0.72-0.87) and stroke (HR 0.48, 95% CI 0.42-0.54).
  • No significant reduction was observed for myocardial infarction (MI) (HR 1.03, 95% CI 0.92-1.15) or all-cause mortality (HR 0.93, 95% CI 0.64-1.37).
  • Sensitivity analyses confirmed these findings.

Conclusions:

  • Combined nicorandil and BBs treatment may be more effective than BBs alone in reducing long-term MACE in CAD patients.
  • This combination therapy shows potential for improving cardiovascular outcomes in CAD management.
Abstract

Keywords:
anginabeta-adrenergic receptor blockerscoronary artery diseasemajor adverse cardiovascular eventsnicorandil

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