Iloprost prevents contrast-induced nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention.
Circulation
; 120(18): 1793-9, 2009 Nov 03.
Article
en En
| MEDLINE
| ID: mdl-19841299
ABSTRACT
BACKGROUND:
The prevention of contrast-induced nephropathy, which accounts for considerable morbidity and mortality, remains a vexing problem. Contrast-induced renal vasoconstriction is believed to play a pivotal role in the pathogenesis of contrast-induced nephropathy. The aim of this study was to examine the efficacy of the prostacyclin analog iloprost in preventing contrast-induced nephropathy in patients with renal dysfunction undergoing a coronary procedure. METHODS ANDRESULTS:
We conducted a randomized, double-blind, placebo-controlled trial of iloprost in 208 patients with a serum creatinine concentration >or=1.4 mg/dL who underwent coronary angiography and/or intervention. Iloprost 1 ng kg(-1) min(-1) or placebo was administered intravenously beginning 30 to 90 minutes before and ending 4 hours after the procedure. Contrast-induced nephropathy was defined by an absolute increase in serum creatinine >or=0.5 mg/dL or a relative increase >or=25% measured 2 to 5 days after the procedure. Contrast-induced nephropathy occurred in 23 of the 105 patients (22%) in the control group and in 8 of the 103 patients (8%) in the iloprost group (odds ratio, 0.29; 95% confidence interval, 0.12 to 0.69; P=0.005). In the control group, the estimated glomerular filtration rate declined from 49.7+/-15.5 to 46.6+/-16.6 mL min(-1) 1.73 m(-2) (P=0.01). In the iloprost group, the estimated glomerular filtration rate increased marginally from 47.5+/-14.5 to 48.6+/-16.1 mL min(-1) 1.73 m(-2) (P=0.26). The mean absolute estimated glomerular filtration rate decline in the control group was greater than its change in the iloprost group (difference, 4.2 mL min(-1) 1.73 m(-2); 95% confidence interval, 1.1 to 7.3; P=0.008).CONCLUSIONS:
Prophylactic administration of iloprost may protect against contrast-induced nephropathy in high-risk patients undergoing a coronary procedure.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Iloprost
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Angiografía Coronaria
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Medios de Contraste
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Nefritis
Tipo de estudio:
Clinical_trials
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Circulation
Año:
2009
Tipo del documento:
Article
País de afiliación:
Grecia