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The effect of trimetazidine on preventing contrast-induced nephropathy after cardiac catheterization
Xingji Lian1, Wenfei He2, Huimin Zhan3
1Department of Nephrology, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510100, Guangzhou, Guangdong, China.
Insights
Trimetazidine did not prevent contrast-induced nephropathy (CIN) in unselected patients undergoing percutaneous coronary intervention (PCI). The drug also showed no significant effect on major adverse clinical events.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Contrast-induced nephropathy (CIN) is a risk for patients undergoing percutaneous coronary intervention (PCI).
- Trimetazidine has shown potential renal protective effects in specific patient groups.
- Its efficacy in unselected PCI patients remains unclear.
Purpose of the Study:
- To evaluate the effectiveness of trimetazidine in preventing CIN.
- To assess the impact of trimetazidine on major adverse clinical events in unselected PCI patients.
Main Methods:
- A study involving 2154 patients undergoing PCI.
- Patients were divided into a trimetazidine group (n=529) and a non-trimetazidine group (n=1625).
- Trimetazidine was administered 24 hours before PCI until discharge; CIN was the primary outcome.
Main Results:
- The incidence of CIN was similar between groups (9.1% vs. 9.2%, P=0.947).
- Adjusted analysis showed no significant reduction in CIN risk with trimetazidine (OR=0.70, P=0.104).
- No significant differences were observed in major adverse clinical events.
Conclusions:
- Trimetazidine does not provide significant renal protection against CIN in unselected PCI patients.
- The drug did not reduce in-hospital major adverse clinical events.
Purpose:
Trimetazidine has been shown to prevent the risk of contrast-induced nephropathy (CIN) in patients with renal dysfunction undergoing percutaneous coronary intervention (PCI). However, the effect of trimetazidine on CIN in unselected patients is unknown. We aimed to evaluate the effect of trimetazidine on preventing CIN in unselected patients treated with PCI.
Methods:
2154 consecutive patients were enrolled and divided into the trimetazidine (n = 529) and non-trimetazidine group (n = 1625). Patients in the trimetazidine group received trimetazidine 20 mg thrice daily starting at least 24 h before the procedure and continuing until discharge. The primary outcome was CIN.
Results:
CIN was observed in 197 (9.2%) patients. The incidence of CIN was similar between two groups (9.1% vs. 9.2%, P = 0.947). After adjusting for other potential risk factors, trimetazidine did not significantly reduce the risk of CIN (OR = 0.70, 95% CI 0.46-1.08, P = 0.104). The results remained similar when using the alternate definitions of CIN and different subgroup analysis based on diabetes or chronic kidney disease. In additional, no significant difference between two groups was found with respect to in-hospital major adverse clinical events (1.89% vs. 1.66%, P > 0.05).
Conclusions:
Trimetazidine did not exert significant renal protective effect on preventing CIN and in hosptial major adverse clinical events in unselected patients undergoing PCI.
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