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Renoprotective effect of nicorandil in patients undergoing percutaneous coronary
intervention: a meta-analysis of 4 randomized controlled trials
#MMPMID29545940
Wang X
; Geng J
; Zhu H
; Xing C
Oncotarget
2018[Feb]; 9
(14
): 11837-11845
PMID29545940
show ga
Many studies have evaluated the renoprotective effect of nicorandil in patients
undergoing percutaneous coronary intervention (PCI), but the results are
inconsistent. We therefore conducted this meta-analysis to evaluate the
protective effect of nicorandil against contrast-induced nephropathy (CIN). We
searched PubMed, Embase, the Cochrane Library, Web of Science, and clinical
trials database. Studies compared the nicorandil (plus hydration) with hydration
alone in patients receiving PCI were eligible. The primary outcome was the
incidence of CIN. Four randomized controlled trials (RCTs) with 730 patients were
included. All enrolled patients were with renal dysfunction or with moderate risk
for CIN. Meta-analysis showed that nicorandil was associated with a decrease of
CIN (odds ratio 0.33, 95% confidence interval [CI], 0.19~0.58, p < 0.001),
without heterogeneity across the studies (I(2) = 33.7%, p = 0.210). Moreover,
nicorandil treatment could significantly reduce the level of serum creatinine,
estimated glomerular filtration rate and cystatin C at 48 hours after procedures
(standardized mean difference [SMD] -0.17, 95%CI -0.33~-0.01; SMD 0.29, 95% CI
0.11~0.48; SMD -0.17, 95%CI -0.33~-0.01, respectively). Nicorandil can reduce the
incidence of CIN and result in favorable changes in renal function in patients
undergoing PCI. More RCTs with large sample size and high quality are needed to
confirm our results.
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