Nicorandil decreases cardiac events during and after noncardiac surgery

Abstract Study Objective To assess whether nicorandil reduces the likelihood of cardiac events during and after intermediate risk surgery. Design Multicenter study. Setting 13 hospitals in Japan. Patients Intermediate-risk patients were identified by the presence of risk factors such as angina, a history of myocardial infarction, heart failure, diabetes mellitus, and abnormal electrocardiography (ECG). Interventions Nicorandil was given to these patients during the operation. Measurements and Main Results Cardiac events during the operation and the following 5 days were monitored. The frequency of cardiac events in nicorandil-treated patients was compared with those in nontreated patients. Eighty-four patients received nicorandil during surgery and 237 patients received standard care. Cardiac events in the nicorandil-treated group occurred less frequently both during the operation (odds ratio, 0.15; 95% confidence interval, 0.03-0.76; P = 0.02) and after it (odds ratio, 0.24; 95% confidence interval, 0.06-0.90; P = 0.04). Conclusions Nicorandil reduces the frequency of cardiac events in patients undergoing noncardiac surgery, both during and after the operation.