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Comparison of Carvedilol and Metoprolol for Preventing Contrast-Induced
Nephropathy after Coronary Angiography
#MMPMID26195972
Y?lmaz M
; Ayd?nalp A
; Okyay K
; Tekin A
; Bal UA
; Bayraktar N
; Y?ld?r?r A
; Müderriso?lu H
Cardiorenal Med
2015[Jun]; 5
(3
): 199-207
PMID26195972
show ga
AIMS: Contrast-induced nephropathy (CIN) is one of the most common causes of
hospital-acquired acute renal failure. Oxidative stress and vasoconstriction
might play key roles in its pathogenesis. In a few experimental models,
antioxidant properties of carvedilol have been documented. The aim of this study
was to analyze and compare the effects of carvedilol and metoprolol on the
development of CIN in patients undergoing coronary angiography. METHODS: One
hundred patients currently taking metoprolol and 100 patients currently taking
carvedilol were enrolled into the study. Venous blood samples were obtained
before and 48 h after contrast administration. Cystatin C and malondialdehyde
values were examined and compared. CIN was defined as a creatinine increase of at
least 25% or 0.5 mg/dl from the baseline value. RESULTS: Seven patients in the
carvedilol group (7%) and 22 patients in the metoprolol group (22%) developed CIN
(p = 0.003). In the metoprolol group, the median cystatin C concentration
increased significantly from 978 to 1,086 ng/ml (p = 0.001) 48 h after
radiocontrast administration. In the carvedilol group, the median cystatin C
concentration did not change significantly (1,143 vs. 1,068 ng/ml; p = 0.94). In
the metoprolol group, the mean malondialdehyde concentration increased
significantly from 7.09 ± 1.48 to 8.38 ± 2.6 nmol/l (p < 0.001). In the
carvedilol group, the mean serum malondialdehyde concentration did not change
significantly (7.44 ± 1.21 vs. 7.56 ± 1.11 nmol/l; p = 0.59). CONCLUSION: When
compared to metoprolol, carvedilol might decrease oxidative stress and subsequent
development of CIN.