Trimetazidine in the Prevention of Contrast-Induced Nephropathy After Coronary Procedures

Alper O Onbasili ^1*, Yavuz Yenicerioglu ², Pnar Agaoglu ¹, Aslihan Karul ³, Tarkan Tekten ¹, Harun Akar ² and Guzel Discigil ⁴

¹ Department of Cardiology, Adnan Menderes University, Turkey
² Department of Nephrology, Adnan Menderes University, Turkey
³ Department of Biochemistry, Adnan Menderes University, Turkey
⁴ Department of Familiy Medicine, Adnan Menderes University, Turkey

^* To whom correspondence should be addressed. E-mail: onbasili{at}isbank.net.tr.

Accepted 19 September 2006

Abstract

Background This study was designed to evaluate the efficacy of trimetazidine (TMZ) in the prevention of contrast induced nephropathy (CIN) in patients with high serum creatinine levels undergoing coronary angiography/angioplasty.

Methods Eighty-two (25 Female, 57 Male, mean age 60iÀ10 years) consecutive patients with a serum creatinin level i1,2 mg/dl undergoing coronary procedures were randomly assigned into two groups: TMZ (n=40) and control (n=42). Trimetazidine (20 mg t.i.d.) was administered orally. All patients were given intravenous saline (0,9%) at a rate of 1 ml/kg of body weight per hour. Serum creatinine concentrations were measured before, 48 hours and 7 days after the procedure. Increase in serum creatinine level exceeding 0,5 mg/d or 1/4 of basal is considered as CIN. Venous blood samples for serum total antioxidant capacity (TAC) measurement were drawn before and after coronary angiography.

Results Basal serum creatinine levels and TAC were similar in TMZ and control groups. However, serum creatinine levels 2 days after the procedure in the control group increased significantly and it returned to the baseline values at 7th day. However, it did not change significantly at 2nd day and even significantly decreased at 7th day in TMZ group. CIN developed 2,5% (1/40) of patients in the TMZ group and in 16,6% (7/42) of patients in the control group (p<0.05). TAC values were not different between treatment groups.

Conclusion TMZ along with isotonic saline infusion is more effective than isotonic saline alone in reducing the risk of CIN in patients with preexisting renal dysfunction.

Keywords: Contrast-induced nephropathy, Coronary intervention, Trimetazidine

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