title: The efficacy of N-acetylcysteine plus sodium bicarbonate in the prevention of contrast-induced nephropathy after cardiac catheterization and percutaneous coronary intervention: A meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The efficacy of combining use of N-acetylcysteine (NAC) and sodium bicarbonate (SOB) in the prevention of contrast-induced nephropathy (CIN) after cardiac catheterization and percutaneous coronary intervention (PCI) is unclear.
  
  
  METHODS
  All relevant studies that compared the effect of combining the use of NAC and SOB with individual use on CIN in patients undergoing cardiac catheterization and PCI were identified by searching the databases including Pubmed, Embase, Cochrane Library, and Web of Science without time and language limitation. Only randomized controlled trials (RCTs) with full-text published were considered.
  
  
  RESULTS
  Sixteen RCTs involving 4432 cases were included into this meta-analysis. The results showed there were no additional benefit in reduction of CIN in COM group (COM versus NAC: RR 0.85, 95% CI 0.70-1.03, P=0.103; COM versus SOB: RR 0.91, 95% CI 0.71-1.16, P=0.449), even in patients with diabetes mellitus (COM versus NAC: RR 1.11, 95% CI 0.71-1.75, P=0.646; COM versus SOB: RR 1.06, 95% CI 0.45-2.47, P=0.893), undergoing PCI procedure (COM versus NAC: RR0.76, 95% CI 0.39-1.47, P=0.411; COM versus SOB: RR0.96, 95% CI 0.65-1.40, P=0.814), or with baseline renal dysfunction (COM versus NAC: RR 0.89, 95% CI 0.70-1.14, P=0.366; COM versus SOB: RR 0.95, 95% CI 0.67-1.36, P=0.788).
  
  
  CONCLUSIONS
  The present study demonstrated combining use of NAC and SOB was not significantly superior to individual use method in the prevention of CIN after cardiac catheterization and PCI.
authors.affiliation: Department of Geriatric Cardiology, First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Shi-Jie
authors.initials: SJ
authors.lastname: Zhao
authors.affiliation: Department of Respiratory, Central Hospital of Shenyang Medical College, Shenyang, China.
authors.forename: Zhao-Shuang
authors.initials: ZS
authors.lastname: Zhong
authors.affiliation: Department of Geriatric Cardiology, First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Guo-Xian
authors.initials: GX
authors.lastname: Qi
authors.affiliation: Department of Geriatric Cardiology, First Affiliated Hospital of China Medical University, Shenyang, China. Electronic address: dr_wentian@163.com.
authors.forename: Wen
authors.initials: W
authors.lastname: Tian
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage*; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000639:trends; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000639:trends; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D017693:Sodium Bicarbonate / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D017693:Sodium Bicarbonate; D000111:Acetylcysteine
keywords: Cardiac catheterization; Contrast-induced nephropathy; N-acetylcysteine; Percutaneous coronary intervention; Sodium bicarbonate