کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2936939 1576401 2006 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Comparison of N-acetylcysteine and fenoldopam for preventing contrast-induced nephropathy (CAFCIN)
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Comparison of N-acetylcysteine and fenoldopam for preventing contrast-induced nephropathy (CAFCIN)
چکیده انگلیسی

BackgroundN-acetylcysteine and fenoldopam are commonly prescribed for prevention of contrast mediated nephropathy, however, comparative superiority of either agent is unknown.MethodsIn a prospective, randomized, parallel-group trial, adult cardiac catheterization patients at the university and veterans' hospitals with pre-existing stable renal insufficiency were randomized to N-acetylcysteine 600 mg orally twice daily for 4 doses or fenoldopam 0.1 mcg/kg/min intravenously for a minimum of 8 h. All patients received intravenous hydration with normal saline (5% dextrose in normal saline for diabetics on insulin). Randomization was stratified for diabetes. The primary endpoint was mean change in Scr at 72 h. Secondary endpoint was the incidence of contrast-induced nephropathy (25% increase above baseline Scr or absolute increase of 0.5 mg/dL).ResultsStudy termination occurred after ninety-five patients (mean age 68 ± 10 years, female 25%, diabetic 42%, mean baseline Scr 1.5 ± 0.4 mg/dL) were randomized, with 84 completing follow-up (44 N-acetylcysteine, 40 fenoldopam). Overall, there were no significant differences in mean change in Scr at 72 h (N-acetylcysteine 0.20 ± 0.72 vs. fenoldopam 0.08 ± 0.48 mg/dL, p = 0.4) or incidence of contrast-induced nephropathy (N-acetylcysteine 5 vs fenoldopam 8, p = 0.4). No differences were detected in subgroup analyses for diabetes, baseline Scr > 1.7 or 2.0 mg/dL, gender, age > 70 years, or contrast volume > 150 mL. Results were similar after multivariate adjustment for diabetes, contrast volume, heart failure and gender.ConclusionsOur randomized comparison failed to demonstrate a significant difference in the abilities of N-acetylcysteine and fenoldopam to prevent the decline in renal function or the incidence of contrast-induced nephropathy during cardiac catheterization.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Cardiology - Volume 109, Issue 3, 24 May 2006, Pages 322–328
نویسندگان
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