Trimetazidine Decreases Risk of Contrast-Induced Nephropathy in Patients With Chronic Kidney Disease: A Meta-Analysis of Randomized Controlled Trials.

Autor:	Nadkarni GN; Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA gnadkarni1178@gmail.com., Konstantinidis I; Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Patel A; Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Yacoub R; Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Kumbala D; Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Patel RA; Division of Cardiology, Department of Medicine, Ochsner Clinic Foundation, Jefferson, LA, USA., Annapureddy N; Division of Rheumatology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA., Pakanati KC; Department of Medicine, Baton Rouge General Hospital, Baton Rouge, LA, USA., Simoes PK; Department of Medicine, St. Luke's Roosevelt Hospital Center at Mount Sinai, New York, NY, USA., Javed F; Division of Cardiology, Department of Medicine, Ochsner Clinic Foundation, Jefferson, LA, USA., Benjo AM; Division of Cardiology, Department of Medicine, Ochsner Clinic Foundation, Jefferson, LA, USA.
Jazyk:	angličtina
Zdroj:	Journal of cardiovascular pharmacology and therapeutics [J Cardiovasc Pharmacol Ther] 2015 Nov; Vol. 20 (6), pp. 539-46. Date of Electronic Publication: 2015 Feb 24.
DOI:	10.1177/1074248415573320
Abstrakt:	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. (© The Author(s) 2015.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu