Role of Colchicine in Prevention of Contrast Induced Nephropathy in Patient Undergoing Primary Percutaneous Coronary Intervention
| Autor: | El Hammady, Hazem M Khorshed Walid A, M M Farouk, Omar M Elhodhod |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Relative risk reduction
medicine.medical_specialty business.industry medicine.medical_treatment Urology Contrast-induced nephropathy Percutaneous coronary intervention General Medicine medicine.disease medicine.disease_cause chemistry.chemical_compound surgical procedures operative chemistry Diabetes mellitus Medicine Colchicine In patient business Oxidative stress |
| Zdroj: | QJM: An International Journal of Medicine. 114 |
| ISSN: | 1460-2393 1460-2725 |
| DOI: | 10.1093/qjmed/hcab090.032 |
| Popis: | Background Contrast-induced nephropathy (CIN) is a frequent complication after intravascular contrast media administration. The incidence of CIN in STEMI patients undergoing primary PCI is around 19.8%. The pathophysiologic basis of CIN includes an oxidative stress and inflammatory process, and colchicine has been used as an anti-inflammatory and anti-oxidant agent to improve cardiovascular outcomes, hence the aim of the current study is to demonstrate the effect of colchicine on CIN in patients undergoing primary PCI. Patients and methods 100 STEMI patients planned for primary PCI were enrolled in this study. They were randomized into two groups of fifty patients: A control group receiving standard guideline based medical treatment alone and a study group receiving same treatment in addition to colchicine. CIN was defined based on serum creatinine that was measured repeatedly over 3 days, with absolute rise of 0.5mg/dl or relative rise of 25% or more from baseline signifying CIN. Results There was a trend towards lower CIN incidence, although not statistically significant, in patients receiving colchicine, in whom CIN incidence was 8%, in comparison to incidence of 20 in those receiving standard guideline-based therapy alone % (χ2 = 2.99 & p = 0.083) with relative risk reduction of 60%. The reduction of CIN incidence was found to be statistically significant in diabetic subgroup, with CIN incidence of 32% in those receiving standard guideline-based therapy alone, in comparison to incidence of 7% in those receiving colchicine with p = 0.033. Multiple regression analysis including colchicine as a covariable concluded that colchicine use was the most important CIN risk lowering factor in the current study (β = -0.223 and p = 0.039). Conclusion There was a trend towards lower incidence of CIN in patients undergoing primary PCI receiving colchicine, although not statistically significant. However, this trend became significant when studied in diabetic subgroup. |
| Databáze: | OpenAIRE |
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