Renoprotective effect of nicorandil in patients undergoing percutaneous coronary intervention: a meta-analysis of 4 randomized controlled trials
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Xiaobing Wang1,2,*, Jin Geng3,*, Hong Zhu4 and Changying Xing1
1Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
2Department of Nephrology, Taizhou Second People’s Hospital, Taizhou, Jiangsu, China
3Department of Cardiology, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an, Jiangsu, China
4Department of Pharmacy, Huai’an First People’s Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
*These authors contributed equally to this work
Changying Xing, email: [email protected]
Keywords: nicorandil; contrast-induced nephropathy; renal function; PCI; meta-analysis
Received: October 11, 2017 Accepted: November 13, 2017 Published: January 04, 2018
Many studies have evaluated the renoprotective effect of nicorandil in patients undergoing percutaneous coronary intervention (PCI), but the results are inconsistent. We therefore conducted this meta-analysis to evaluate the protective effect of nicorandil against contrast-induced nephropathy (CIN). We searched PubMed, Embase, the Cochrane Library, Web of Science, and clinical trials database. Studies compared the nicorandil (plus hydration) with hydration alone in patients receiving PCI were eligible. The primary outcome was the incidence of CIN. Four randomized controlled trials (RCTs) with 730 patients were included. All enrolled patients were with renal dysfunction or with moderate risk for CIN. Meta-analysis showed that nicorandil was associated with a decrease of CIN (odds ratio 0.33, 95% confidence interval [CI], 0.19~0.58, p < 0.001), without heterogeneity across the studies (I2 = 33.7%, p = 0.210). Moreover, nicorandil treatment could significantly reduce the level of serum creatinine, estimated glomerular filtration rate and cystatin C at 48 hours after procedures (standardized mean difference [SMD] –0.17, 95%CI –0.33~–0.01; SMD 0.29, 95% CI 0.11~0.48; SMD –0.17, 95%CI –0.33~–0.01, respectively). Nicorandil can reduce the incidence of CIN and result in favorable changes in renal function in patients undergoing PCI. More RCTs with large sample size and high quality are needed to confirm our results.
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