Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Pharmacol Res Perspect. 2024 Aug;12(4):e1228. doi: 10.1002/prp2.1228.
Contrast-induced nephropathy (CIN) is a serious complication that occurs subsequent to the administration of contrast media for therapeutic angiographic interventions. As of present, no effective therapy exists to prevent its occurrence. This single-center double-blind randomized controlled trial aimed to evaluate the effect of edaravone, an antioxidant, in a group of high-risk patients undergoing coronary angiography. Ninety eligible patients with chronic kidney disease Stages 3-4 were randomly assigned to either the control group (n = 45) or the intervention group (n = 45). In the intervention group, one dosage of edaravone (60 mg) in 1 L of normal saline was infused via a peripheral vein 1 h prior to femoral artery-directed coronary angiography. Patients in the control group received an equal amount of infusion in their last hour before angiography. Both groups received intravenous hydration with 0.9% sodium 1 mL/kg/h starting 12 h before and continuing for 24 h after angiography. The primary outcome measure was the onset of CIN, defined as a 25% increase in serum creatinine levels 120 h after administration of contrast media. The occurrence of CIN was observed in 5.5% (n = 5) of the studied population: 2.2% of patients in the intervention group (n = 1) and 8.9% of controls (n = 4). However, this difference was not statistically significant. Administration of a single dosage of edaravone 1 h prior to infusion of contrast media led to a reduction in the incidence of CIN. Further investigations, employing larger sample sizes, are warranted to gain a comprehensive understanding of its efficacy.
对比剂肾病(CIN)是一种严重的并发症,发生在接受治疗性血管造影介入的对比剂后。目前,尚无有效的治疗方法可以预防其发生。这项单中心、双盲、随机对照试验旨在评估抗氧化剂依达拉奉对接受冠状动脉造影的高危患者的作用。90 名符合条件的慢性肾脏病 3-4 期患者被随机分为对照组(n=45)和干预组(n=45)。在干预组中,在股动脉导向冠状动脉造影前 1 小时,外周静脉输注 1 升生理盐水加依达拉奉 1 次(60mg)。对照组患者在造影前最后 1 小时接受相同剂量的输注。两组患者均在造影前 12 小时开始,持续 24 小时静脉滴注 0.9%氯化钠 1ml/kg/h。主要结局指标是 CIN 的发生,定义为造影剂给药后 120 小时血清肌酐水平升高 25%。研究人群中有 5.5%(n=5)发生 CIN:干预组有 2.2%(n=1)的患者和对照组有 8.9%(n=4)的患者。然而,这一差异无统计学意义。在输注对比剂前 1 小时给予单次剂量的依达拉奉可降低 CIN 的发生率。需要进一步的研究,采用更大的样本量,以全面了解其疗效。