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Contrast-induced nephropathy (CIN) is a frequent complication after coronary angiography. In the exclusion of saline hydration, the effectiveness of other means of prevention remains unclear, and almost poor. Thanks to its pleotropic effects, statins have been used in CIN prevention, but data remains controversial.
To evaluate the benefit of statins in the prevention of CIN after coronary angiography.
We used the database of a randomized controlled trial conducted in the Cardiology B department of Monastir's Hospital during the period March to November 2010 to study the effectiveness of ascorbic acid in the prevention of CIN. Patients undergoing coronary angiography were randomly assigned to a saline hydration prevention protocol or a saline hydration associated to ascorbic acid protocol. The primary endpoint was the occurrence of CIN defined as a creatinin arise of more than 25% the baseline level during the following 48 to 72 hours. The relationship between statin intake at baseline and CIN incidence was retrospectively evaluated using a Chi-square test.
Among the 202 patients included, 126 (62.3%) were treated with statins. There was no significant difference between the two groups concerning the baseline characteristics, particularly in ascorbic acid treatment (p=0.94). CIN incidence dropped from 20.8% in the patients not taking statins to 11.7% in those treated with statins. This resulted in a tendency (p=0.08) but difference wasn't statistically significant, probably due to the small sample of the population.
In our study, treatment with statins led to a trend to reduce CIN incidence. The small sample of the population couldn't allow stronger conclusion. Statins seem to be promising but larger trials are needed.
- 2013 American College of Cardiology Foundation