Table 2.
Summary of clinical trials related to CIN protective effects of different pharmacological strategies.
| Substance | CIN protection | No CIN protection |
|---|---|---|
| Ascorbic acid | Meta-analysis of nine RCTs, 33% lower CIN risk if compared to either placebo or to alternative pharmacological regimen (risk ratio by random-effects model: 0.672; 95% confidence interval, 0.466 to 0.969; p = 0.034) [13] | Meta-analysis of multiple substances including ascorbic acid, no superiority as compared to saline (odds ratio active treatment versus saline: 1.84; 95% confidence interval: 0.16 to 24.98) [14] |
|
| ||
| Fenoldopam | None | (i) Prospective, placebo-controlled, double-blind, multicenter RCT, CIN incidences in fenoldopam versus placebo: 33.6 versus 30.1%; p = 0.61 [15] (ii) Prospective, randomized trial, CIN incidences in saline versus saline + fenoldopam versus saline + ACC: 15.3 versus 15.7 versus 17.1%; p = 0.9 [16] |
|
| ||
| Probucol | (i) Prospective, randomized trial, CIN incidences in probucol + hydration versus hydration alone: 4 versus 10.9%; p value significant [17] (ii) Meta-analysis of multiple substances including probucol, further odds ratio reduction with probucol odds ratio active treatment versus saline 0.27; 95% confidence interval: 0.09 to 0.79 [14] |
None |
|
| ||
| Prostaglandins | Two meta-analyses indicated beneficial effects of different types of prostaglandins in CIN prevention [14, 18] | None |
|
| ||
| Statins | (i) Benefit of combined administration of high-dose statins and saline [19] (ii) Meta-analysis published by Liang et al.: diabetic subjects benefit from moderate or high-dose rosuvastatin [20] |
None |
|
| ||
| Theophylline | Beneficial effects in three trials [21–23] | None |
|
| ||
| Tocopherol | (i) Rezaei et al. [24]: additional administration of tocopherol prior to elective coronary intervention lowered CIN risk further (ii) Benefit in two other randomized controlled trials [25, 26] |
None |
|
| ||
| Trimetazidine | Meta-analysis published by Ye and colleagues [18]: 6 randomized controlled trials indicate additional CIN protection by the substance | None |