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Preventing Contrast-Induced Acute Kidney Injury in Egyptian Patients Undergoing Coronary Angiography: A Randomized

Sarah Sabry1,2, Mai K Ammar3, Mahmoud Taeima4

  • 1The Cardiovascular Hospital, Ain Shams University, 110 Ibn Fadlan Street, Nasr City, Cairo, Egypt. ssabry@ecu.edu.eg.

Clinical Drug Investigation
|February 17, 2026
PubMed

Insights

High-dose atorvastatin and N-acetylcysteine (NAC) can help prevent contrast-induced acute kidney injury (CI-AKI) after coronary angiography. Statins demonstrated more significant CI-AKI reduction than NAC, supporting prophylactic strategies for high-risk patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Contrast-induced acute kidney injury (CI-AKI) is a significant complication following coronary angiography (CAG).
  • Preventive strategies for CI-AKI are crucial, especially in patients undergoing elective CAG.
  • Limited evidence exists on effective CI-AKI prevention methods in this patient population.

Purpose of the Study:

  • To compare the efficacy of high-dose N-acetylcysteine (NAC) plus hydration versus high-dose atorvastatin (HDS) plus hydration versus hydration alone in preventing CI-AKI.
  • To evaluate CI-AKI prevention strategies in patients undergoing elective coronary angiography.
  • To assess the impact of NAC and HDS on CI-AKI incidence post-CAG.

Main Methods:

  • A prospective, multi-armed randomized comparative study involving 120 patients undergoing elective CAG.
  • Patients were assigned to three groups: control (hydration), NAC (1200 mg daily for 5 days + hydration), or HDS (80 mg atorvastatin 24h prior + hydration).
  • CI-AKI was defined as a serum creatinine increase >25% or 0.5 mg/dL within 48 hours post-procedure.

Main Results:

  • The incidence of CI-AKI was 32.5% in the control group, 20% in the NAC group, and 12.5% in the HDS group.
  • High-dose atorvastatin significantly reduced CI-AKI incidence compared to the control group (RR = 1.658).
  • No statistically significant differences in in-hospital clinical outcomes were observed among the three groups.

Conclusions:

  • Both N-acetylcysteine and high-dose atorvastatin show potential in reducing CI-AKI incidence following coronary angiography.
  • High-dose statins appear to be more effective than NAC in preventing CI-AKI.
  • Prophylactic strategies, particularly high-dose statins, are supported for CI-AKI prevention in high-risk patients undergoing CAG.
Abstract

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