title: Strategies Preventing Contrast-Induced Nephropathy After Coronary Angiography: A Comprehensive Meta-Analysis and Systematic Review of 125 Randomized Controlled Trials.
abstract: This systematic review with meta-analysis sought to determine the strength of evidence for the effects of hydration (sodium bicarbonate [SB] and normal saline [NS]), supplementations ( N-acetylcysteine [NAC] and vitamin C), and some common drugs (adenosine antagonists [AAs], statins, loop diuretics, and angiotensin-converting enzyme inhibitors [ACEIs]) on the incidence of contrast-induced nephropathy (CIN) and requirement for hemodialysis after coronary angiography. After screening, a total of 125 trials that reported outcomes were identified. Pooled analysis indicated beneficial effects of SB versus NS (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.56-0.94; P = .01), NAC (OR = 0.79; 95% CI: 0.70-0.88; P = .001), vitamin C (OR = 0.64; 95% CI: 0.45-0.89; P = .01), statins (OR = 0.45; 95% CI: 0.35-0.57; P = .001), AA (OR = 0.28; 95% CI: 0.14-0.47; P = .001), loop diuretics (OR = 0.97; 95% CI: 0.33-2.85; P = .9), and ACEI (OR = 1.06; 95% CI: 0.69-1.61; P = .8). Overall, hydration with SB, use of supplements, such as NAC and vitamin C, and administration of statins and AA should always be considered for the prevention of CIN after coronary angiography.
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Sadeq
authors.initials: S
authors.lastname: Ali-Hasan-Al-Saegh
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Seyed Jalil
authors.initials: SJ
authors.lastname: Mirhosseini
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Ghodratipour
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sarrafan-Chaharsoughi
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Rahimizadeh
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Karimi-Bondarabadi
authors.affiliation: 2 Department of Physiology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Haddad
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Shahidzadeh
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Mahdavi
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Ali-Mohammad
authors.initials: AM
authors.lastname: Dehghan
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mahbube
authors.initials: M
authors.lastname: Tahernejad
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Shahidzadeh
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Dehghan
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Azam
authors.initials: A
authors.lastname: Ghanei
authors.affiliation: 1 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Lotfaliani
authors.affiliation: 3 Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.|4 Department of Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Weymann
authors.affiliation: 3 Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Zeriouh
authors.affiliation: 3 Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Aron-Frederik
authors.initials: AF
authors.lastname: Popov
authors.affiliation: 3 Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Anton
authors.initials: A
authors.lastname: Sabashnikov
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D003287:Contrast Media
keywords: N-acetylcysteine; adenosine antagonist; angiotensin-converting enzyme inhibitors; antioxidants; contrast-induced nephropathy; hydration; loop diuretics; normal saline; sodium bicarbonate; statins; vitamin C