Potential pharmacological prophylactic agents
| Drug name | Study | Outcome: treatment vs control |
|---|---|---|
| High-dose statins | PRATO-ACS study76 n=504 Marenzi et al77 n=1134 | CIN 6.7% vs 15.1% OR 0.38; 95% CI 0.20 to 0.71; p=0.003 CIN 5.5% vs 15% RR=0.37; 95% CI 0.25 to 0.55; p<0.0001 |
| N-acetyl cysteine | Gonzales et al73 Meta-analysis n=2746 | High-quality RCTs—no CIN benefit RR=0.87; 95% CI 0.68 to 1.12, p=0.28 Low-quality RCTs—high CIN benefit RR=0.15; 95% CI 0.07 to 0.33, p<0.0001 |
| Ascorbic acid | Spargias et al,96 RCT n=231 | CIN 9% vs 20% OR 0.38 95% CI 0.17 to 0.85; P=0.02 |
| Theophylline | Ix et al97 Meta-analysis, n=480 | Difference in mean SCr 11.5 µmol/L 95% CI 5.3 to 19.4 µmol/L, p=0.004 |
| Iloprost | Spargias et al98 RCT n=208 | CIN 8% vs 20% OR 0.29 95% CI 0.12 to 0.69; p=0.005 |
| Prostaglandin E1 | Li et al99 n=163, RCT | CIN 3.7 vs 11.1% p<0.05 |
| Trimetazidine | Shehata et al,100 RCT n=100 | CIN 12% vs 28% (p<0.05) (lower Troponin-T in Trimetazidine group) |
| Atrial natriuretic peptide | Morikawa et al,101 RCT n=254 | CIN 3.2% vs 11.7% OR 0.24; p=0.016 |
Conflicting or negative evidence.
Fenoldopam,102 dopamine,103 calcium channel blockers,104 L-arginine,105 furosemide without matched
hydration,106 mannitol,107 endothelin receptor antagonists.108
CIN, contrast-induced nephropathy; RCT, randomised controlled trial; RR, relative risk; SCr, serum creatinine.