Oral N-acetylcysteine for prophylaxis of contrast-induced nephropathy in patients following coronary angioplasty: A meta-analysis

It is acknowledged that contrast-induced nephropathy (CIN) is a common cause of acute renal insufficiency after cardiac catheterization and affects mortality and morbidity. To date, it is unknown whether oral N-acetylcysteine (NAC) is able to prevent contrast-induced nephropathy (CIN) in patients un...

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Bibliographic Details
Published in:Experimental and therapeutic medicine 2017-08, Vol.14 (2), p.1568-1576
Main Authors: Li, Jing-Xiu, Jin, En-Ze, Yu, Long-Hao, Li, Yang, Liu, Nan-Nan, Dong, Yu-Mei, Li, Xin, Li, Xue-Qi
Format: Article
Language:English
Subjects:
Acetylcysteine
Angioplasty
cardiac catheterization
Care and treatment
Clinical medicine
Clinical trials
Complications and side effects
contrast-induced nephropathy
Coronary angiography
Diabetes
Dosage and administration
Health aspects
Hydration
Kidney diseases
Meta-analysis
N-acetylcysteine
Prevention
Studies
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Summary:It is acknowledged that contrast-induced nephropathy (CIN) is a common cause of acute renal insufficiency after cardiac catheterization and affects mortality and morbidity. To date, it is unknown whether oral N-acetylcysteine (NAC) is able to prevent contrast-induced nephropathy (CIN) in patients undergoing coronary angioplasty. A meta-analysis of randomized controlled trials was performed to assess the effects of NAC in the prevention of CIN in patients following coronary angioplasty. A total of 19 studies published prior to January 2015 that investigated the efficacy of oral NAC for the prevention of CIN were collected from Medline, Cochrane and Embase databases and conference proceedings from cardiology and nephrology meetings. The primary point of investigation was CIN, and the secondary points were renal failure requiring dialysis, mortality and length of hospitalization. The meta-analysis was performed using fixed- or random-effect models according to heterogeneity. Up to January 2015, 19 randomized placebo-controlled clinical trials met the inclusion criteria for the meta-analysis, including 4,514 patients. The pooled data showed that oral NAC did not reduce the CIN incidence [relative risk 0.84, 95% confidence interval (CI) 0.65-1.10; P=0.20], without heterogeneity among trials (I2=29%). Thus, the present meta-analysis suggests that oral NAC therapy is not effective as an alternative treatment to prevent CIN in patients following angioplasty. Further high quality randomized clinical controlled trials are required to confirm the usage and availability of this treatment.
ISSN:1792-0981
1792-1015
DOI:10.3892/etm.2017.4678