A Bayesian network meta-analysis of preventive strategies for contrast-induced nephropathy after cardiac catheterization
| Autor: | Haris Riaz, Safi U. Khan, Muhammad U. Khan, Muhammad Shahzeb Khan, Hammad Rahman, Matthew Novak, Isaac Opoku-Asare, Edo Kaluski |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty Statin medicine.drug_class medicine.medical_treatment Network Meta-Analysis Contrast-induced nephropathy Contrast Media 030204 cardiovascular system & hematology Placebo Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Renal Dialysis Risk Factors law Internal medicine medicine Humans 030212 general & internal medicine Aged Randomized Controlled Trials as Topic Cardiac catheterization business.industry Bayes Theorem General Medicine Odds ratio Acute Kidney Injury Middle Aged Protective Factors medicine.disease Acetylcysteine Sodium Bicarbonate Relative risk Female Hemodialysis Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular Revascularization Medicine. 20:29-37 |
| ISSN: | 1553-8389 |
| DOI: | 10.1016/j.carrev.2018.06.005 |
| Popis: | Background The optimal preventive strategy for contrast induced acute kidney injury (CIAKI) in patients undergoing cardiac catheterization remains uncertain. Objective We conducted Bayesian network meta-analysis (NMA) to compare different preventive strategies for CIAKI in these cohorts. Methods Forty-nine randomized controlled trials were extracted using MEDLINE, EMBASE and CENTRAL data bases (inception-1st December 2017). We calculated median of the odds ratio (OR) with the corresponding 95% credible interval (CrI). The ranking probability of each treatment was based on SUCRA (surface under the cumulative ranking curve). Results In NMA of 28,063 patients [normal saline (NS: 9716 patients), sodium bicarbonate (NaHCO3: 4484 patients), statin (2542 patients), N-acetylcysteine (NAC: 3006 patients), NAC + NaHCO3 (774 patients), NS + NAC (3807 patients), NS + NaHCO3 (135 patients) and placebo (3599 patients)], statins reduced the relative risk of CIAKI compared with NS (OR: 0.50; 95% CrI, 0.25–0.99), and placebo (OR: 0.44; 95% CrI, 0.24–0.83). Subgroup analyses showed that in patients receiving low osmolar contrast, statins reduced the relative risk of CIAKI by 58% versus NS, and 51% versus placebo. There were no significant differences across all the treatments in terms of risk of hemodialysis or all-cause mortality . Statins had the highest probability for reducing the risk of CIAKI (SUCRA, 0.86), risk of hemodialysis (SUCRA, 0.88) and all-cause mortality (SUCRA, 0.81). Conclusion Statins were the superior preventive strategy for reducing the risk of CIAKI compared with NS alone and placebo. |
| Databáze: | OpenAIRE |
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