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2017 ; 96
(9
): e6059
Nephropedia Template TP
gab.com Text
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Clinical effect of trimetazidine on prevention of contrast-induced nephropathy in
patients with renal insufficiency: An updated systematic review and
meta-analysis
#MMPMID28248861
Ye Z
; Lu H
; Su Q
; Guo W
; Dai W
; Li H
; Yang H
; Li L
Medicine (Baltimore)
2017[Mar]; 96
(9
): e6059
PMID28248861
show ga
BACKGROUND: With the continuous development of cardiac interventional medicine,
the incidence of contrast-induced nephropathy (CIN) is increasing every year,
which is a serious threat to people's physical and mental health. Trimetazidine
(TMZ) is a type of anti-ischemic drug developed in recent years, which can
significantly reduce the incidence of CIN. At present, a systematic review and
meta-analysis was conducted to evaluate the clinical effect of TMZ on prevention
of CIN in patients with renal insufficiency. However, the study did not include
patients from other countries and speaking different languages. So we conducted
this study to update the previous meta-analysis that investigated the effects of
TMZ on prevention of CIN in patients with renal insufficiency, and provided some
theoretical reference for clinical. METHODS: By searching PubMed, Embase, the
Cochrane Library, Web of Science, CBM, CNKI, VIP database, and Wang Fang database
for randomized controlled trial, which is comparing TMZ versus conventional
hydration for prevention of CIN. Two researchers independently screened
literature, and then evaluated the quality of literature and extracted the
relevant data. Stata 11.0 software was used for statistical analysis. RESULTS:
Finally, this updated review showed that 3 studies that were not included in the
previous meta-analysis were included in our study (3 articles were published in
the Chinese Journal, 1 study for CIN, 1 study for CIN, serum creatinine (Scr),
and superoxide dismutase, 1 study for CIN and Scr), and 1 outcome (Scr)
reflecting the change of renal function was additionally included in our study.
Of the 932 studies, 6 randomized controlled trials met the criteria, including
377 patients in TMZ group and 387 patients in control group. This meta-analysis
for all studies showed that TMZ can significantly reduce the incidence of CIN
(relative risk 0.27, 95% confidence interval [CI] 0.16, 0.46, P?=?0.000), and can
decrease the level of Scr after operation, including Scr of postoperative
24?hours (standardized mean difference [SMD] -0.30, 95% CI -0.51, -0.09,
P?=?0.005), Scr of postoperative 48?hours (SMD -0.66, 95% CI -1.23, -0.10,
P?=?0.022), and Scr of postoperative 7 days (SMD -0.74, 95% CI -1.36, -0.11,
P?=?0.021). However, the Scr of postoperative 72?hours between TMZ group and
control group has no statistical significance (P?=?0.362). CONCLUSION: Our study
showed that when comparing with conventional hydration, TMZ can significantly
reduce the incidence of CIN and the level of postoperative Scr. Therefore, we
could suggest that TMZ was superior to conventional hydration for the treatment
of CIN in patients with renal insufficiency. However, due to the restriction of
quality and number of included articles, it still needs to carry out multicenter,
randomized, double-blind clinical trials to confirm this conclusion in the
future.
|Contrast Media/*adverse effects
[MESH]
|Creatinine/blood
[MESH]
|Humans
[MESH]
|Incidence
[MESH]
|Renal Insufficiency/blood/epidemiology/etiology/*prevention & control
[MESH]
free
free
free
