Related Experiment Video
Updated: Feb 14, 2026
Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment
Published on: April 19, 2024
Comparative efficacy of pharmacological interventions for contrast-induced nephropathy prevention after coronary
Wen-Qi Ma1, Yu Zhao2, Ying Wang1
1Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao, Nanjing, 210009, People's Republic of China.
Insights
This network meta-analysis found that statin plus N-acetylcysteine (NAC) and intravenous saline is the most effective strategy for preventing contrast-induced nephropathy (CIN) after coronary angiography. Some treatments also reduced short-term mortality but did not impact dialysis needs or major adverse events.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following contrast media administration in patients undergoing coronary angiography (CAG).
- Existing research on pharmacological interventions for CIN prevention shows inconsistent results.
- A network meta-analysis was conducted to systematically evaluate the comparative effectiveness of various pharmacological treatments for CIN prevention.
Purpose of the Study:
- To assess the relative efficacy of eleven pharmacological interventions in preventing contrast-induced nephropathy (CIN).
- To identify the most effective pharmacological strategies for CIN prevention in patients undergoing coronary angiography (CAG).
- To evaluate the impact of these interventions on short-term mortality, dialysis requirements, and major adverse cardiac and cerebrovascular events (MACCE).
Main Methods:
- A comprehensive literature search was performed across multiple databases (MEDLINE, EMBASE, Cochrane, ClinicalTrials.gov) up to July 2017.
- Included were randomized controlled trials (RCTs) evaluating eleven distinct pharmacological interventions for CIN prevention.
- Network meta-analysis was employed to synthesize data from 107 studies involving 21,450 participants.
Main Results:
- Compared to intravenous saline alone, several pharmacological interventions significantly reduced CIN incidence, including statin, N-acetylcysteine (NAC), vitamin analogues, brain natriuretic peptide (BNP) analogues, prostaglandin analogues, NAC plus sodium bicarbonate (SB), and statin plus NAC.
- The top-ranked interventions for CIN prevention were statin plus NAC, BNP analogues, statin, and vitamin analogues.
- NAC plus intravenous saline was associated with a lower incidence of short-term all-cause mortality, but no intervention demonstrated a reduction in dialysis requirement or MACCE.
Conclusions:
- The combination of statin, NAC, and intravenous saline appears to be the most effective strategy for preventing CIN in patients post-CAG.
- NAC combined with intravenous saline may offer a protective effect against short-term mortality.
- Current pharmacological interventions do not effectively reduce the need for dialysis or the occurrence of MACCE.
Background:
Contrast-induced nephropathy (CIN) is the major complication related to contrast media administration in patients after coronary angiography (CAG). However, inconsistent results have been published in the literature regarding the effects of pharmacological drugs on CIN prevention. We conducted a network meta-analysis to evaluate the relative efficacy of pharmacological interventions for the prevention of CIN.
Methods:
We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to July 2017. We included any randomized controlled trials of eleven pharmacological interventions that reported the prevention of CIN.
Results:
We identified 3850 records through database searches, of which 107 studies comprising 21,450 participants were finally identified. Compared with intravenous saline, intravenous saline plus pharmacological drugs including statin [relative risk (RR) 0.57; 95% credibility interval (CrI) 0.39 to 0.83], N-acetylcysteine (NAC) (RR 0.84; 95% CrI, 0.71 to 0.98), vitamin and its analogues (RR 0.66; 95% CrI 0.45 to 0.97), brain natriuretic peptide (BNP) and its analogues (RR 0.46; 95% CrI 0.30 to 0.70), prostaglandin analogues (RR 0.37; 95% CrI 0.18 to 0.76), NAC plus sodium bicarbonate (SB) (RR 0.60; 95% CrI 0.39 to 0.90), and statin plus NAC (RR 0.39; 95% CrI 0.21 to 0.70), have helped to reduce the incidence of CIN in patients after CAG. The top four ranked treatments were statin plus NAC, BNP and its analogues, statin, and vitamin and its analogues, respectively. NAC plus intravenous saline was associated with lower incidence of short-term all-cause mortality than intravenous saline alone (RR 0.62; 95% CI, 0.40 to 0.96; P = 0.03). However, no evidence indicated that any of the pharmacological drugs were associated with a reduced requirement for dialysis and major adverse cardiac and cerebrovascular events (MACCE).
Conclusions:
Statin plus NAC plus intravenous saline seems to be the most effective treatment for the prevention of CIN in patients after CAG. NAC plus intravenous saline may have a protective role against short-term all-cause mortality. However, none of these drugs has effectively decreased the requirement for dialysis and MACCE.
Related Concept Videos
01:26Coronary Artery Disease IV: Preventive Measures
01:20Comparing the Survival Analysis of Two or More Groups
01:12Statistical Software for Data Analysis and Clinical Trials
02:26Protein Networks
These interactions can be represented through maps depicting protein-protein interaction networks, represented as nodes and edges. Nodes are circles that are representative of a protein,...
01:03Nursing Interventions I: Taxonomy of Nursing Interventions
A nursing intervention is a treatment or action based on scientific concepts and knowledge from the nursing, behavioral, and physical sciences. Identifying and prioritizing nursing interventions based on the desired outcome...
01:29Self-Efficacy