Vol 12, No 5 (2016):238-242

Pentoxifylline and prevention of contrast-induced nephropathy: Is it efficient in patients with myocardial infarction undergoing coronary angioplasty?

Ali Eshraghi, Roya Naranji-Sani, Hourak Pourzand, Mohammad Vojdanparast, Negar Morovatfar, Javad Ramezani, Ramin Khamene-Bagheri, Pouya Nezafati

Abstract


BACKGROUND: Contrast-induced nephropathy (CIN) is a major concern following procedures with applying iodinated contrast media. The basis prevention of CIN is hydration and to avoid hypovolemia. We aimed to evaluate the efficacy of pentoxifylline (PTX) for the prevention of CIN in patients with myocardial infarction (MI) undergoing coronary angioplasty.

METHODS: This prospective, single-blind, randomized clinical trial study was performed on
175 (127 men) of MI patients undergoing routine treatment. Patients were assigned randomly to the control (n = 84) and study groups (n = 91). In our study group, patients received 400 mg/3 times a day from 24 hours before to 24 hours after coronary angiography. In addition, before the procedure and after 48 hours from the procedure, serum creatinine was measured.

RESULTS: CIN occurred in 14 patients (8.0%); 8 controls (9.5%) and 6 patients (6.6%) in the PTX group )P = 0.475) showing PTX to have no significant effect on CIN [P = 0.750, odds
ratio = 0.82 (confidence interval = 0.24-2.8)] though a significantly different volume of contrast was used between the groups (231.29 ± 105.10 mm3 and 190.88 ± 75.82 mm3; P = 0.005, respectively).

CONCLUSION: There was no significantly different occurrence of CIN on patients with MI, undergoing coronary angioplasty, but its relatively lower rate in PTX group would recommend the prophylactic oral use of PTX for CIN prevention.

 


Keywords


Pentoxifylline; Myocardial Infarction; Contrast Media; Angioplasty; Nephropathy; Creatinine

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References


McCullough P. Renal complications of contrast media. In: King SB 3rd, Yeung AC, Editors. Interventional Cardiology. New York, NY: McGrawHill Medical; 2007.

McCullough PA, Wolyn R, Rocher LL, Levin RN, O'Neill WW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997; 103(5): 368-75.

Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 2002; 105(19): 2259-64.

Best PJ, Lennon R, Ting HH, Bell MR, Rihal CS, Holmes DR, et al. The impact of renal insufficiency on clinical outcomes in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol 2002; 39(7): 1113-9.

Busch SV, Jensen SE, Rosenberg J, Gogenur I. Prevention of contrast-induced nephropathy in STEMI patients undergoing primary percutaneous coronary intervention: a systematic review. J Interv Cardiol 2013; 26(1): 97-105.

Pyxaras SA, Sinagra G, Mangiacapra F, Perkan A, Di Serafino L, Vitrella G, et al. Contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention without acute left ventricular ejection fraction impairment. Am

Cardiol 2013; 111(5): 684-8.

Chiou YL, Shieh JJ, Lin CY. Blocking of Akt/NF-kappaB signaling by pentoxifylline inhibits platelet-derived growth factor-stimulated proliferation in Brown Norway rat airway smooth muscle cells. Pediatr Res 2006; 60(6): 657-62.

Yavari V, Ostovan MA, Kojuri J, Afshariani R, Hamidian Jahromi A, Roozbeh J, et al. The preventive effect of pentoxifylline on contrast-induced nephropathy: a randomized clinical trial. Int Urol Nephrol 2014; 46(1): 41-6.

Kelly AM, Dwamena B, Cronin P, Bernstein SJ, Carlos RC. Meta-analysis: effectiveness of drugs for preventing contrast-induced nephropathy. Ann Intern Med 2008; 148(4): 284-94.

Brar SS, Shen AY, Jorgensen MB, Kotlewski A, Aharonian VJ, Desai N, et al. Sodium bicarbonate vs sodium chloride for the prevention of contrast medium-induced nephropathy in patients undergoing coronary angiography: a randomized trial. JAMA 2008; 300(9): 1038-46.

Roozbeh J, Hamidian Jahromi A, Sharifian M, Pakfetrat M, Afshariani R. Protective effect of pentoxifylline on contrast induced nephropathy. Saudi J Kidney Dis Transpl 2008; 19(6): 985-6.

Spargias K, Alexopoulos E, Kyrzopoulos S, Iokovis P, Greenwood DC, Manginas A, et al. Ascorbic acid prevents contrast-mediated nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. Circulation 2004; 110(18): 2837-42.

Zhang J, Fu X, Jia X, Fan X, Gu X, Li S, et al. B-type natriuretic peptide for prevention of contrast-induced nephropathy in patients with heart failure undergoing primary percutaneous coronary intervention. Acta Radiol 2010; 51(6): 641-8.

Mehran R, Aymong ED, Nikolsky E, Lasic Z, Iakovou I, Fahy M, et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J Am Coll Cardiol 2004; 44(7): 1393-9.

Firouzi A, Eshraghi A, Shakerian F, Sanati HR, Salehi N, Zahedmehr A, et al. Efficacy of pentoxifylline in prevention of contrast-induced nephropathy in angioplasty patients


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