Comparing Trimetazidine with Allopurinol in Prevention of Contrast Induced Nephropathy After Coronary Angiography

Abstract

Objectives: Contrast-induced nephropathy is considered a serious complication following coronary angiography increasing morbidity and mortality. Various drugs have been assessed to reduce the incidence of contrast-induced nephropathy. In this study, we compared trimetazidine and allopurinol as a pharmacological measure to reduce the incidence of contrast-induced nephropathy. Methods: One hundred and twenty patients undergoing coronary angiography with baseline creatinine clearance more than 30 ml/minute were divided into three groups, 40 patients each. Group 1 received standard parenteral intravenous hydration in the form of isotonic saline at a rate of 1 ml/kg body weight per hour started 12 hours before angiography and up to 12 hours after the procedure. Group 2 received trimetazidine 35 mg twice per day for 72 hours starting 48 hours before the procedure in addition to intravenous hydration. Group 3 received allopurinol 300 mg once daily for 72 hours starting 48 hours before the procedure in addition to intravenous hydration. Serum creatinine and creatinine clearance were measured before and 72 hours after the procedure in addition to the volume of contrast media used. Results: Trimetazidine and allopurinol failed to reduce contrast-induced nephropathy significantly. Among patients with contrast-induced nephropathy volume of contrast media was significantly higher. Conclusion: Adding trimetazidine or allopurinol in addition to regular intravenous hydration with isotonic saline without targeting selectively high-risk patients did not reduce contrast-induced nephropathy following coronary angiography

Protective effect of recombinant human brain natriuretic peptide against contrast-induced nephropathy in elderly acute myocardial infarction patients: A randomized controlled trial

“…Now, increasing studies have reported that PCI has become the best and preferred treatment option for AMI, saving many lives. With the popularization of PCI technology and more patients undergoing PCI operation, there has been an increase in the cases of contrast-induced nephropathy (CIN), which is one of the major reasons for iatrogenic renal failure, increasing the risk of death during hospitalization, hospitalization expenses, and hospital stays[ 4 - 6 ]. Since there are many side effects of drug therapy in elderly patients with cardiovascular diseases in China, PCI is more often used, thus leading to a higher incidence CIN.…”