A Meta-analysis Of The Efficacy And Safety Of Nicorandil In Patie Nts With Ischemic Cardiomyopathy And Heart Failure

Objective:To understand the efficacy and safety of Nicorandil in the treatment of patients with ischemic cardiomyopath(ICM)and heart failure,and to provide evidence-based evidence for clinical use.Methods:In English,the terms "Nicorandil","Ischemic cardiomyopath,ICM" and "heart failure" were used.In Chinese,the search terms were "Nicorandil","Ischemic cardiomyopathy","heart failure",etc.English search Pubmed,Embase,Wed of Science,Cochrane Library,Chinese search China Knowledge Network Database(CNKI),Wanfang Database,Wipu Chinese Science and Technology Journal Database,China Biomedical Literature Database,the search deadline is January 1,2023.We collected all the randomized controlled trials on the effectiveness and safety of nicorandil in the treatment of ischemic cardiomyopathy combined with heart failure published at home and abroad,evaluated the quality of the included literature objectively,extracted the data strictly and accurately,and conducted Meta-analysis using Rev Man 5.4 software on the literature that met the criteria.Results:A total of 13 studies containing 1068 patients were included,with 535 patients in the trial group treated with conventional anti-heart failure therapy plus nicorandil and 533 patients in the control group treated with conventional anti-heart failure therapy.The results of meta-analysis showed that the left ventricular ejection fraction(LVEF)was increased in the left ventricular ejection fraction(LVEF)compared with the control group[MD=11.42,95% CI(10.60 to 12.25),P<0.001];Reduction of left ventricular end systolic diameter(LVESD)[MD=-8.40,95% CI(-8.90,-7.91),P<0.001];Reduction of left ventricular end diastolic diameter(LVEDD)[MD=-5.35,95% CI(-6.16,-4.54),P<0.001];Six minutes walk test(6MWD)[MD=80.99,95%CI(38.47,123.50),P=0.0002];Improvements in cardiac function(Improvement in cardiac function,that is,the total effective rate of treatment = effective + effective,effective refers to NYHA cardiac function class improvement of 2 or more,effective refers to NYHA cardiac function class improvement of 1)[OR=4.12,95%CI(2.63,6.46),P<0.001];There was no significant difference in the incidence of adverse reactions.[OR=0.66,95% CI(0.39 to 1.10),P=0.11].Conclusions:Oral nicorandil,in addition to conventional anti-heart failure therapy,can improve cardiac function and inhibit ventricular remodeling in patients with ischemic cardiomyopathy combined with heart failure in the short term.