Zhan Biming, Huang Xiao, Jiang Long, Bao Huihui, Cheng XiaoShu
1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Angiology. 2018 Aug;69(7):568-573. doi: 10.1177/0003319717732237. Epub 2017 Sep 26.
Several studies have investigated the effect of nicorandil on contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). However, the final results of these trials are not identical. This meta-analysis evaluated the role of nicorandil administration on CIN prevention. We searched databases to find randomized controlled trial (RCT) comparing nicorandil with hydration versus conventional hydration therapy on preventing CIN. Finally, 5 articles (805 patients) were included in our meta-analysis; the data showed that nicorandil was related to significant reduction in the risk of CIN (risk ratio = 0.37, 95% confidence interval [CI]: 0.22-0.61, P = .0001). We found not only the cystatin C level after operation was nonsignificant between 2 groups at the first 24 hours ( P = .65, 95% CI = -0.06 to 0.04) and 48 hours ( P = .19, 95% CI = -0.11 to 0.02) but also the serum creatinine level was nonsignificantly elevated, at 24 hours ( P = .46, 95% CI = -5.19 to 1.88) and 72 hours ( P = .49, 95% CI = -0.49 to 0.34). Our analysis suggested that the nicorandil treatment compared with conventional hydration can significantly reduce the risk of CIN.
多项研究调查了尼可地尔对接受冠状动脉造影(CAG)或经皮冠状动脉介入治疗(PCI)的患者造影剂肾病(CIN)的影响。然而,这些试验的最终结果并不相同。这项荟萃分析评估了尼可地尔给药在预防CIN中的作用。我们检索数据库以寻找比较尼可地尔与水化治疗和传统水化疗法预防CIN的随机对照试验(RCT)。最终,5篇文章(805例患者)纳入了我们的荟萃分析;数据显示,尼可地尔与CIN风险显著降低相关(风险比=0.37,95%置信区间[CI]:0.22-0.61,P=.0001)。我们发现,不仅两组术后24小时(P=.65,95%CI=-0.06至0.04)和48小时(P=.19,95%CI=-0.11至0.02)的胱抑素C水平无显著差异,而且血清肌酐水平在24小时(P=.46,95%CI=-5.19至1.88)和72小时(P=.49,95%CI=-0.49至0.34)也无显著升高。我们的分析表明,与传统水化治疗相比,尼可地尔治疗可显著降低CIN风险。