1 / 18

IONA

IONA. I mpact O f N icorandil in A ngina A Presentation given by Henry J Dargie Western Infirmary and University of Glasgow at the AHA Conference 14th Nov 2001. IONA. Background : Angina is common - affects over 10% of men and women over 60 Angina is disabling

arnold
Télécharger la présentation

IONA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. IONA Impact Of Nicorandil in Angina A Presentation given by Henry J Dargie Western Infirmary and University of Glasgow at the AHA Conference 14th Nov 2001

  2. IONA • Background : • Angina is common - affects over 10% of men and women over 60 • Angina is disabling - quality of life can be poor • Angina affects outcome variably - 3% to 20% annual rate of cardiac events

  3. Anti anginal : nitrates beta blockers Ca++ channel blockers nicorandil Disease modifying : anti-platelet statin ACE inhibitors IONA- current medical treatment of angina

  4. IONA • Objective : To investigate the impact of nicorandil on outcome in patients with angina of effort - when added to existing treatments

  5. IONA • Primary Hypothesis : Treatment with nicorandil will reduce the incidence of the primary endpoint by 25% • Primary End Point : Coronary Heart Disease Death + Non fatal Myocardial Infarction + Unplanned Hospitalisation for Cardiac Chest Pain

  6. IONA • Secondary End Point : • Coronary Heart Disease Death • + • Non Fatal Myocardial Infarction

  7. IONA • Exploratory Analyses : • All cause mortality • All cardiovascular events

  8. IONA • Design and Methodology : • Double blind, randomised controlled trial of nicorandil versus placebo • 10 mg bd increasing to 20 mg bd after 2 weeks • Higher risk patients on existing medication • not being actively considered for revascularisation • Conducted exclusively in the UK • recruitment from hospital and primary care • Analysis was by intention to treat

  9. IONA • Inclusion criteria • Men or women • Stable angina with high risk features • Need for regular oral anti anginal medication (long acting nitrate, beta blocker or calcium channel blocker)

  10. IONA • Recruitment and follow up • 5126 patients recruited • 2561 (P), 2565 (N) • Average follow up of 1.6 years • (1- 3 years)

  11. Male (%) 76 Smoker (%) 16 Previous MI (%) 66 PTCA/CABG (%) 34 Diabetes (%) 8 Hypertension (%) 46 PVD (%) 12 Stroke/TIA (%) 7 Age (years) 67 SBP (mmHg) 138 DBP (mmHg) 79 CCSF (%) I 27 II 62 III 11 IV 1 IONA Baseline characteristics

  12. Antiplatelet 88 -blocker 56 Ca-antagonist 55 Nitrate 86 Statin 57 ACE inhibitor 29 Insulin 3.4 Hypoglycaemic 2.1 IONA Baseline therapy (%)

  13. (RRR = 17%, P = 0.014) Nicorandil Placebo

  14. Nicorandil (RRR = 21%, P=0.068) Placebo

  15. (RRR = 13%, P = 0.27) Nicorandil Placebo

  16. (RRR = 15%, P = 0.025) Nicorandil Placebo

  17. IONA • Summary • In patients with chronic stable angina: • Nicorandil significantly reduced the incidence of major coronary events and all cardiovascular events • IONA is the first large scale clinical trial to report on the effects of a specific anti - anginal medication on clinical outcome

  18. Anti anginal : nitrates beta blockers Ca++ channel blockers nicorandil Disease modifying : anti-platelet statin ACE inhibitors nicorandil IONA-future medical treatment of angina

More Related