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Prevention of contrast-induced nephropathy with prostaglandin E1 in high-risk patients undergoing percutaneous
Wen-Hua Li1, Dong-Ye Li, Wen-Hao Qian
1Department of Cardiology, Affiliated Hospital of XuZhou Medical College, No. 99 Huaihai West Road, Xuzhou, 221002, China, wenhualicn@yeah.net.
Insights
Prostaglandin E1 (PGE1) effectively prevents contrast-induced nephropathy (CIN) in high-risk patients undergoing percutaneous coronary intervention (PCI). This safe and efficacious treatment reduces CIN incidence compared to standard hydration.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following procedures using iodinated contrast media.
- Patients undergoing percutaneous coronary intervention (PCI) are at risk for CIN, necessitating preventative strategies.
Purpose of the Study:
- To evaluate the safety and efficacy of Prostaglandin E1 (PGE1) in preventing CIN.
- To assess PGE1's role in high-risk patients undergoing PCI.
Main Methods:
- A randomized controlled trial involving 163 patients undergoing PCI.
- Patients received either PGE1 infusion or standard saline hydration.
- Serum creatinine and estimated glomerular filtration rate were monitored post-contrast administration.
Main Results:
- The incidence of CIN was significantly lower in the PGE1 group (3.7%) compared to the control group (11.1%).
- Similar volumes of contrast media were administered to both groups.
- No serious adverse events were reported in the PGE1 group.
Conclusions:
- Prostaglandin E1 is a safe and effective agent for preventing CIN in high-risk patients undergoing PCI.
- PGE1 offers a promising therapeutic option to mitigate contrast-related kidney injury.
Purpose:
Contrast-induced nephropathy (CIN) is an important complication in the use of iodinated contrast media. The present study aimed to assess the safety and efficacy of prostaglandin E1 (PGE1) in prevention of CIN in patients with high-risk factors undergoing percutaneous coronary intervention (PCI).
Methods:
The study group consisted of 163 patients who had undergone a coronary intervention procedure between January 1, 2012 and October 31, 2012. Study participants were randomly assigned to either the PGE1 group (82 patients) or the control group (81 patients). Patients in the PGE1 group received PGE1 intravenous infusion of 20 ng/kg/min for 6 h before and after the administration of contrast media. The control group received 0.9 % sodium chloride solution for routine hydration only. A nonionic, low-osmolality contrast agent was used in our laboratory at this time. Serum creatinine (Scr) values and estimated glomerular filtration rate were measured before and within 48 h of the administration of contrast agents. CIN was defined as an increase of ≥0.5 mg/dL or ≥ a 25 % increase in Scr concentrations over baseline within 48 h of angiography.
Results:
The amount of contrast agent administered was similar for the PGE1 and control groups (156 ± 63 vs. 161 ± 68 mL, P > 0.05). The incidence of CIN was lower in the PGE1 group than in the control group (3.7 vs. 11.1 %, P < 0.05). No serious adverse effects were observed.
Conclusions:
In patients with high-risk factors undergoing PCI, the use of PGE1 for prevention of CIN is safe and efficacious.
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