Strategies preventing contrast-induced nephropathy after coronary angiography: a comprehensive meta-analysis and systematic review of 125 randomized controlled trials

This systematic review with meta-analysis sought to determine the strength of evidence for the effects of hydration (sodium bicarbonate [SB] and normal saline [NS]), supplementations ( N-acetylcysteine [NAC] and vitamin C), and some common drugs (adenosine antagonists [AAs], statins, loop diuretics,...

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Hauptverfasser: Ali-Hasan-Al-Saegh, Sadeq (VerfasserIn) , Weymann, Alexander (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2017
In: Angiology
Year: 2017, Jahrgang: 68, Heft: 5, Pages: 389-413
ISSN:1940-1574
DOI:10.1177/0003319716661445
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1177/0003319716661445
Volltext
Verfasserangaben:Sadeq Ali-Hasan-Al-Saegh, Seyed Jalil Mirhosseini, Zahra Ghodratipour, Zahra Sarrafan-Chaharsoughi, Elham Rahimizadeh, Ali Akbar Karimi-Bondarabadi, Fatemeh Haddad, Arezoo Shahidzadeh, Parisa Mahdavi, Ali-Mohammad Dehghan, Mahbube Tahernejad, Azadeh Shahidzadeh, Hamidreza Dehghan, Azam Ghanei, Mohammadreza Lotfaliani, Alexander Weymann, Mohamed Zeriouh, Aron-Frederik Popov, Anton Sabashnikov

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520 |a This systematic review with meta-analysis sought to determine the strength of evidence for the effects of hydration (sodium bicarbonate [SB] and normal saline [NS]), supplementations ( N-acetylcysteine [NAC] and vitamin C), and some common drugs (adenosine antagonists [AAs], statins, loop diuretics, and angiotensin-converting enzyme inhibitors [ACEIs]) on the incidence of contrast-induced nephropathy (CIN) and requirement for hemodialysis after coronary angiography. After screening, a total of 125 trials that reported outcomes were identified. Pooled analysis indicated beneficial effects of SB versus NS (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.56-0.94; P = .01), NAC (OR = 0.79; 95% CI: 0.70-0.88; P = .001), vitamin C (OR = 0.64; 95% CI: 0.45-0.89; P = .01), statins (OR = 0.45; 95% CI: 0.35-0.57; P = .001), AA (OR = 0.28; 95% CI: 0.14-0.47; P = .001), loop diuretics (OR = 0.97; 95% CI: 0.33-2.85; P = .9), and ACEI (OR = 1.06; 95% CI: 0.69-1.61; P = .8). Overall, hydration with SB, use of supplements, such as NAC and vitamin C, and administration of statins and AA should always be considered for the prevention of CIN after coronary angiography. 
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