Andrea Marie Reyes
St. Luke’s Medical Center, Philippines
Title: Efficacy of Nicorandil in the Prevention of Contrast-Induced Nephropathy among Patients with Chronic Kidney Disease Undergoing Coronary Angiography: a meta-analysis of randomized controlled trials
Biography
Biography: Andrea Marie Reyes
Abstract
Contrast-induced nephropathy (CIN) is a reversible form of acute kidney injury that occurs soon after administration of contrast media. Current accepted methods for prevention of CIN include intravenous (IV) hydration, administration of oral n-acetylcysteine, and use of atorvastatin. Nicorandil, a novel anti-anginal drug has been studied to have a beneficial effect as well in preventing CIN. This paper aims to determine the efficacy of nicorandil in the preventing the incidence of contrast-induced nephropathy in patients who will undergo coronary angiography. Search for randomized controlled trials was done, evaluating the efficacy of nicorandil in preventing contrast-induced nephropathy in patients undergoing coronary angiography. Articles were critically appraised for inclusion. Pooled analysis revealed a Chi2 value of 4.32, dF=3 (P=0.21), I2 of 31%. Computed relative risk for incidence of CIN following Nicorandil administrations was 38% (CI: 0.19, 0.71). Administration of Nicorandil showed absolute risk reduction in incidence of CIN by 8% as compared to iv hydration seen in the Forest plot with a number needed to treat of 12. It showed a trend favouring nicorandil for the prevention of contrast-induced nephropathy. The studies also showed that nicorandil together with IV hydration significantly caused reduction in cystatin C levels and change from baseline eGFR as compared with standard intravenous hydration.