Table 9

Potential pharmacological prophylactic agents

Drug nameStudyOutcome: treatment vs control
High-dose statinsPRATO-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 cysteineGonzales 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 acidSpargias et al,96 RCT
n=231
CIN 9% vs 20%
OR 0.38 95% CI 0.17 to 0.85; P=0.02
TheophyllineIx 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
IloprostSpargias et al98 RCT
n=208
CIN 8% vs 20% OR 0.29
95% CI 0.12 to 0.69; p=0.005
Prostaglandin E1Li et al99
n=163, RCT
CIN 3.7 vs 11.1%
p<0.05
TrimetazidineShehata et al,100 RCT
n=100
CIN 12% vs 28% (p<0.05) (lower Troponin-T in Trimetazidine group)
Atrial natriuretic peptideMorikawa 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.