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Trimetazidine in the prevention of contrast-induced nephropathy after coronary procedures
  1. Alper O Onbasili1,
  2. Yavuz Yeniceriglu2,
  3. Pınar Agaoglu1,
  4. Aslıhan Karul3,
  5. Tarkan Tekten1,
  6. Harun Akar2,
  7. Guzel Discigil4
  1. 1Department of Cardiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
  2. 2Department of Nephrology, School of Medicine, Adnan Menderes University, Aydin, Turkey
  3. 3Department of Biochemistry, School of Medicine, Adnan Menderes University, Aydin, Turkey
  4. 4Department of Family Medicine, School of Medicine, Adnan Menderes University, Aydin, Turkey
  1. Correspondence to:
    Associate Professor Dr A O Onbasili
    Department of Cardiology, School of Medicine, Adnan Menderes University, 09100 Aydin, Turkey; aonbasili{at}adu.edu.tr

Abstract

Objective: 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: TMZ (20 mg thrice daily) was administered orally for 72 h starting 48 h before the procedure. All patients were given intravenous saline (0.9%) at a rate of 1 ml/kg of body weight per hour for 24 h starting 12 h beforehand. Serum creatinine levels were measured before the procedure, 48 h and 7 days after the procedure. Increase in serum creatinine level exceeding 0.5 mg/day or one quarter of the basal value 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. Serum creatinine levels in the control group increased significantly 2 days after the procedure, and returned to the baseline values on the seventh day. However, it did not change significantly on the second day, and even significantly decreased on the seventh day in the TMZ group. CIN developed in 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 pre-existing renal dysfunction.

  • ABTS, 2, 2′-azino-bis-3-ethylbenzothiazoline sulphonate
  • CIN, contrast-induced nephropathy
  • TAC, total antioxidant capacity
  • TMZ, trimetazidine

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Footnotes

  • Published Online First 25 October 2006

  • Competing interests: None declared.

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