title: Preventive effect of oral nicorandil on contrast-induced nephropathy in patients with renal insufficiency undergoing elective cardiac catheterization.
abstract: This study aims to investigate the preventive effect of oral nicorandil on contrast-induced nephropathy (CIN) in patients with renal insufficiency undergoing elective cardiac catheterization. A total of 240 patients with an estimated glomerular filtration rate (eGFR) of 60 mL/min or less, who were undergoing elective cardiac catheterization, were randomly assigned to nicorandil group (n = 120, 10 mg nicorandil, three times daily from 2 days before to 3 days after procedure) or control group (n = 120, matching placebo as the same method). The primary endpoint was the incidence of CIN defined as 25 % increase in serum creatinine (SCr) from baseline or 44 μmol/L (0.5 mg/dL) increase in absolute value within 72 h after exposure to contrast medium. The secondary endpoints were: (1) the changes of SCr, Cystatin-C (Cys-C) and eGFR within 72 h; (2) major adverse events (MACE) occurring within 30 days. Baseline characteristics of the patients in the two groups were similar. The incidence of CIN was significantly lower in nicorandil group compared with control group (6.67 vs. 17.5 %, P = 0.017). Compared with the control group, nicorandil group tended to have a lower SCr and Cys-C levels as well as a higher eGFR at 48 h after the procedure (all P < 0.05). There was no difference about the incidence of MACE within 30 days between nicorandil group and control group (4.16 vs. 5.83 %, P = 0.767). Multivariate logistic analysis showed that nicorandil was an independent protective factor against CIN (OR = 0.260, 95 % CI = 0.1-0.676, P = 0.006). Therefore, we concluded that oral nicorandil was associated with a decline in the incidence of CIN in patients with renal insufficiency undergoing elective cardiac catheterization.
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China. weiqingmin@medmail.com.cn.
authors.forename: Qingmin
authors.initials: Q
authors.lastname: Wei
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Junna
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Yongtang
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Youliang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Limei
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Shupo
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Yilin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lv
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Xingtai People's Hospital, Xingtai, 054000, China.
authors.forename: Ruijuan
authors.initials: R
authors.lastname: Du
mesh_terms: D000284:Administration, Oral; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002681:China; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007472:Iohexol / Q000009:adverse effects / Q000031:analogs & derivatives*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020108:Nicorandil / Q000008:administration & dosage* / Q000009:adverse effects; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D020011:Protective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015641:Radiography, Interventional / Q000009:adverse effects; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D020011:Protective Agents; D020108:Nicorandil; D007472:Iohexol; C038192:iopromide; D003404:Creatinine
keywords: Cardiac catheterization; Contrast-induced nephropathy; Nicorandil; Renal insufficiency