Girish N Nadkarni1, Ioannis Konstantinidis2, Achint Patel3, Rabi Yacoub2, Damodar Kumbala2, Rajan A G Patel4, Narender Annapureddy5, Krishna Chaitanya Pakanati6, Priya K Simoes7, Fahad Javed4, Alexandre M Benjo4. 1. Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA gnadkarni1178@gmail.com. 2. Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 3. Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 4. Division of Cardiology, Department of Medicine, Ochsner Clinic Foundation, Jefferson, LA, USA. 5. Division of Rheumatology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. 6. Department of Medicine, Baton Rouge General Hospital, Baton Rouge, LA, USA. 7. Department of Medicine, St. Luke's Roosevelt Hospital Center at Mount Sinai, New York, NY, USA.
Abstract
OBJECTIVES: We sought to synthesize and analyze the available data from randomized controlled trials (RCTs) for trimetazidine (TMZ) in the prevention of contrast-induced nephropathy (CIN). BACKGROUND: Contrast-induced nephropathy after coronary angiography is associated with poor outcomes. Trimetazidine is an anti-ischemic drug that might reduce incidence of CIN, but current data are inconclusive. METHODS: We searched MEDLINE/PubMed, EMBASE, Scopus, Cochrane Library, Web of Science, and ScienceDirect electronic databases for RCTs comparing intravenous hydration with normal saline (NS) and/or N-acetyl cysteine (NAC) versus TMZ plus NS ± NAC for prevention of CIN. We used RevMan 5.2 for statistical analysis with the fixed effects model. RESULTS: Of the 808 studies, 3 RCTs met criteria with 290 patients in the TMZ plus NS ± NAC group and 292 patients in the NS ± NAC group. The mean age of patients was 59.5 years, and baseline serum creatinine ranged from 1.3 to 2 mg/dL. Trimetazidine significantly reduced the incidence of CIN by 11% (risk difference 0.11; 95% confidence interval, 0.16-0.06; P < .01). There was no significant heterogeneity between the studies (I(2) statistic = 0). The number needed to treat to prevent 1 episode of CIN was 9. CONCLUSIONS: The addition of TMZ to NS ± NAC significantly decreased the incidence of CIN in patients undergoing coronary angiography. In conclusion, TMZ could be considered as a potential tool for prevention of CIN in patients with renal dysfunction.
OBJECTIVES: We sought to synthesize and analyze the available data from randomized controlled trials (RCTs) for trimetazidine (TMZ) in the prevention of contrast-induced nephropathy (CIN). BACKGROUND: Contrast-induced nephropathy after coronary angiography is associated with poor outcomes. Trimetazidine is an anti-ischemic drug that might reduce incidence of CIN, but current data are inconclusive. METHODS: We searched MEDLINE/PubMed, EMBASE, Scopus, Cochrane Library, Web of Science, and ScienceDirect electronic databases for RCTs comparing intravenous hydration with normal saline (NS) and/or N-acetyl cysteine (NAC) versus TMZ plus NS ± NAC for prevention of CIN. We used RevMan 5.2 for statistical analysis with the fixed effects model. RESULTS: Of the 808 studies, 3 RCTs met criteria with 290 patients in the TMZ plus NS ± NAC group and 292 patients in the NS ± NAC group. The mean age of patients was 59.5 years, and baseline serum creatinine ranged from 1.3 to 2 mg/dL. Trimetazidine significantly reduced the incidence of CIN by 11% (risk difference 0.11; 95% confidence interval, 0.16-0.06; P < .01). There was no significant heterogeneity between the studies (I(2) statistic = 0). The number needed to treat to prevent 1 episode of CIN was 9. CONCLUSIONS: The addition of TMZ to NS ± NAC significantly decreased the incidence of CIN in patients undergoing coronary angiography. In conclusion, TMZ could be considered as a potential tool for prevention of CIN in patients with renal dysfunction.
Authors: Eliano P Navarese; Paul A Gurbel; Felicita Andreotti; Michalina Marta Kołodziejczak; Suetonia C Palmer; Sofia Dias; Antonino Buffon; Jacek Kubica; Mariusz Kowalewski; Tomasz Jadczyk; Michał Laskiewicz; Marek Jędrzejek; Maximillian Brockmeyer; Flavio Airoldi; Marinella Ruospo; Stefano De Servi; Wojciech Wojakowski; Christopher O' Connor; Giovanni F M Strippoli Journal: PLoS One Date: 2017-02-02 Impact factor: 3.240
Authors: Aart J van der Molen; Peter Reimer; Ilona A Dekkers; Georg Bongartz; Marie-France Bellin; Michele Bertolotto; Olivier Clement; Gertraud Heinz-Peer; Fulvio Stacul; Judith A W Webb; Henrik S Thomsen Journal: Eur Radiol Date: 2018-02-07 Impact factor: 5.315