title: Continuous intravenous infusion of nicorandil for 4 hours before and 24 hours after percutaneous coronary intervention protects against contrast-induced nephropathy in patients with poor renal function.
abstract: BACKGROUND
  We conducted a prospective randomized trial to assess the protective effect of continuous intravenous infusion of nicorandil against contrast-induced nephropathy (CIN) in patients with poor renal function.
  
  
  RESULTS
  We randomly assigned 213 patients who would subsequently undergo elective percutaneous coronary intervention (PCI) and who had a high serum cystatin C level to a saline group (n=107) or a nicorandil group (n=106, nicorandil infused in addition to saline for 4h before and 24h after PCI). There were no significant differences in baseline characteristics between the two groups. However, the average percent increases in serum creatinine and cystatin C following PCI were significantly smaller in the nicorandil group than the saline group. Likewise, the average percent decline in the estimated glomerular filtration rate was smaller in the nicorandil group. Correspondingly, the incidence of CIN was dramatically lower in the nicorandil group than the saline group (2.0% vs. 10.7%, p<0.02). Univariate regression analysis revealed nicorandil treatment to be the only significant predictor of CIN development (odds ratio: 0.173, 95% confidence interval: 0.037-0.812, p=0.026).
  
  
  CONCLUSIONS
  Nicorandil strongly prevents CIN in patients with poor renal function undergoing PCI.
authors.affiliation: Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Nawa
authors.affiliation: Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. Electronic address: nissy@gifu-u.ac.jp.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nishigaki
authors.affiliation: Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Kinomura
authors.affiliation: Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawasaki
authors.affiliation: Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Minatoguchi
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D003327:Coronary Disease / Q000150:complications / Q000601:surgery; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007262:Infusions, Intravenous; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control; D020011:Protective Agents / Q000008:administration & dosage; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D055316:Cystatin C; D020011:Protective Agents; D020108:Nicorandil; D003404:Creatinine
keywords: Contrast-induced nephropathy; Nicorandil; Prognosis; Randomized trial