Nicorandil for the prevention of contrast-induced nephropathy: A meta-analysis of randomized controlled trials

作者：Ma, Xiaofen; Li, Xiang; Jiao, Zhanfeng; Zhang, Yiming^*

来源：Cardiovascular Therapeutics, 2018, 36(2): e12316.

DOI：10.1111/1755-5922.12316

• contrast-induced nephropathy
• meta-analysis
• nicorandil
• randomized controlled trials

IntroductionNicorandil has been suggested as a preventative strategy against the incidence of contrast-induced nephropathy (CIN). However, results of relevant randomized controlled trials (RCTs) were inconsistent. @@@ AimsWe performed a meta-analysis of RCTs to evaluate the preventive efficacy of periprocedural treatment of nicorandil against the incidence of CIN. @@@ MethodsRelevant RCTs were identified via search of PubMed, Embase, and Cochrane's Library databases. Results were pooled using a random-effect model. Subgroup analyses were performed to evaluate the potential influence of administering routes on the efficacy of nicorandil against CIN incidence. @@@ ResultsFour RCTs with 709 patients were included. Treatment of nicorandil significantly reduced the incidence of CIN as compared with controls (risk ration [RR]: 0.38, 95% confidence interval [CI]: 0.19 similar to 0.74, P=.005) with moderate heterogeneity (I-2=33%). Results of subsequent subgroup analysis showed that nicorandil significantly reduced the risk of CIN if orally administered (RR: 0.32, P<.001), but did not if intravenously administered (RR: 0.47, I-2=68%). Moreover, treatment with nicorandil was associated with significantly less increment of SCr (weight mean difference [WMD]: -3.98%, P<.001) and a tendency of less increment of cystatin C (WMD: -3.86%, P=.08) after 48-hour contrast exposure as compared with controls. @@@ ConclusionsPeriprocedural treatment with nicorandil may be preventative against the incidence of CIN in patients undergoing contrast exposure. The influence of periprocedural nicorandil on clinical outcome in these patients deserves further investigation.

• 出版日期2018-4
• 单位济宁医学院