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Furosemide's Preventative Role in Contrast-Induced Nephropathy among ST-Segment Elevation Myocardial Infarction
Mostafa Ariafar1, Parvin Ghorbani1, Seyed Masoud Seyedian2
1Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Insights
Post-treatment with furosemide did not reduce contrast-induced nephropathy (CIN) risk in ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI. Blood urea nitrogen levels were higher in the furosemide group.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- ST-elevation myocardial infarction (STEMI) is a known risk factor for contrast-induced nephropathy (CIN).
- Diuretics are explored as a preventive measure for CIN, but their efficacy remains uncertain.
- The specific impact of furosemide on CIN risk in STEMI patients requires further investigation.
Purpose of the Study:
- To investigate whether post-treatment with furosemide decreases CIN risk in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).
Main Methods:
- A clinical trial involving 234 STEMI patients undergoing primary PCI.
- Patients were randomized into two groups: furosemide treatment (0.5 mg/kg) or control.
- Serum creatinine and blood urea nitrogen (BUN) were monitored pre- and post-PCI to define CIN.
Main Results:
- CIN occurred in 14.1% of patients at 24 hours and 14.9% at 72 hours, with no significant difference between groups.
- Blood urea nitrogen (BUN) levels were significantly higher in the furosemide group (P < 0.05).
- The furosemide group had a higher proportion of male and smoking patients.
Conclusions:
- Low-dose furosemide combined with standard hydration did not correlate with a lower CIN incidence in STEMI patients undergoing primary PCI.
- Further research with larger sample sizes is needed to elucidate the effects of furosemide in this patient population.
Background:
ST-elevation myocardial infarction (STEMI) is regarded as a risk factor for contrast-induced nephropathy (CIN). Numerous studies have explored preventive measures for CIN such as the use of diuretics. However, the specific impact of diuretics in averting nephropathy remains uncertain. We investigated whether post-treatment with furosemide decreases CIN risk.
Materials And Methods:
We designed a clinical trial and included 234 patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Patients were divided into two groups: Group I (furosemide 0.5 mg/kg) and Group II (control). Serum creatinine and blood urea nitrogen (BUN) were measured pre- and post-surgery. CIN was described as more than either 25% or 0.5 mg/dL induction in serum creatinine from the baseline in 24 h and 72 h post-PCI.
Results:
CIN occurred in 33 patients (14.1%) in 24 h and 35 patients (14.9%) in 72 h. CIN incidence was not significantly different between both groups. However, BUN was significantly higher in the furosemide group (P < 0.05). Most patients in the furosemide group were men and smokers compared to the control group.
Conclusion:
A combination of low-dose furosemide plus standard hydration was not correlated with lower CIN incidence in STEMI patients who are candidates for primary PCI compared to standard hydration only. Further studies with a larger sample size in the future are needed to better understand the effects of this combination.
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