title: Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced Nephropathy after Coronary Angiography.
abstract: OBJECTIVE
  Contrast-induced nephropathy (CIN) is one of the most common causes of hospital-acquired acute renal failure. Oxidative stress and vasoconstriction might play key roles in its pathogenesis. In a few experimental models, antioxidant properties of carvedilol have been documented. The aim of this study was to analyze and compare the effects of carvedilol and metoprolol on the development of CIN in patients undergoing coronary angiography.
  
  
  METHODS
  One hundred patients currently taking metoprolol and 100 patients currently taking carvedilol were enrolled into the study. Venous blood samples were obtained before and 48 h after contrast administration. Cystatin C and malondialdehyde values were examined and compared. CIN was defined as a creatinine increase of at least 25% or 0.5 mg/dl from the baseline value.
  
  
  RESULTS
  Seven patients in the carvedilol group (7%) and 22 patients in the metoprolol group (22%) developed CIN (p = 0.003). In the metoprolol group, the median cystatin C concentration increased significantly from 978 to 1,086 ng/ml (p = 0.001) 48 h after radiocontrast administration. In the carvedilol group, the median cystatin C concentration did not change significantly (1,143 vs. 1,068 ng/ml; p = 0.94). In the metoprolol group, the mean malondialdehyde concentration increased significantly from 7.09 ± 1.48 to 8.38 ± 2.6 nmol/l (p < 0.001). In the carvedilol group, the mean serum malondialdehyde concentration did not change significantly (7.44 ± 1.21 vs. 7.56 ± 1.11 nmol/l; p = 0.59).
  
  
  CONCLUSIONS
  When compared to metoprolol, carvedilol might decrease oxidative stress and subsequent development of CIN.
authors.affiliation: Department of Cardiology, Baskent University, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yılmaz
authors.affiliation: Department of Cardiology, Baskent University, Ankara, Turkey.
authors.forename: Alp
authors.initials: A
authors.lastname: Aydınalp
authors.affiliation: Department of Cardiology, Baskent University, Ankara, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Okyay
authors.affiliation: Department of Cardiology, Baskent University, Ankara, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Tekin
authors.affiliation: Department of Cardiology, Baskent University, Ankara, Turkey.
authors.forename: Uğur Abbas
authors.initials: UA
authors.lastname: Bal
authors.affiliation: Department of Biochemistry, Baskent University, Ankara, Turkey.
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Bayraktar
authors.affiliation: Department of Cardiology, Baskent University, Ankara, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Yıldırır
authors.affiliation: Department of Cardiology, Baskent University, Ankara, Turkey.
authors.forename: Haldun
authors.initials: H
authors.lastname: Müderrisoğlu
keywords: Carvedilol; Contrast-induced nephropathy; Cystatin C; Malondialdehyde; Metoprolol