Preventive Effect of Nicorandil on Contrast-Induced Nephropathy: A Meta-Analysis of Randomized Controlled Trials.
Intern Med J. 2018 May 09;:
Authors: Li S, Wang L, Liu Y, Hu Q
BACKGROUNDS: Contrast-induced nephropathy (CIN) is a common and serious side effect in patients undergoing angiocardiography or radiological procedures. We aimed to comprehensively assess the impact of nicorandil on CIN, by gathering currently available data.
METHODS AND RESULTS: We searched three main electric databases (Medline/PubMed, EMBASE and Cochrane Central Register of Controlled Trials) from inception through April, 2017. Four randomized controlled trials involving 730 participants were included. Pooled estimate showed that nicorandil significantly reduced the rate of CIN by 64% (risk ratio = 0.36, 95% confidence interval (95% CI): 0.22 to 0.61, I2 = 31%), compared with control. Nicorandil also significantly decreased serum creatinine level compared with control (mean difference (MD) = -2.70%, 95% CI: -5.21% to -0.20% for percent change; and standard MD = -0.30, 95% CI: -0.48 to -0.13 for absolute change from baseline). In comparison to control, nicorandil was associated a non-significant trend towards decreased cystatin C (MD = -2.18%, 95% CI: -4.39% to 0.02% for percent change; and MD: -0.08 mg/dl, 95% CI: -0.24 to 0.09 mg/dl for absolute change from baseline).
CONCLUSION: Nicorandil can protect renal function and reduce the incidence of CIN in patients exposed to contrast medium. Nicorandil is an additional option in preventing CIN.
PMID: 29740934 [PubMed - as supplied by publisher]