Cardiology 2013. Part II.
March 9, 2014
Immunoglobulin Fab Fragments/therapeutic use
Myocardial Infarction/prevention & control
Percutaneous Coronary Intervention/*methods
Platelet Aggregation Inhibitors/therapeutic use
Postoperative Hemorrhage/prevention & control
Randomized Controlled Trials as Topic
Notes: Redwood, Simon R
Eur Heart J. 2013 Feb;34(5):338-44. doi: 10.1093/eurheartj/ehs452. Epub 2013 Jan 2.
Author Address: BHF Centre of Excellence, King’s College London, St Thomas’ Campus, Westminster Bridge Road, London SE1 7EH, UK. firstname.lastname@example.org
Reference Type: Journal Article
Record Number: 941Author: Ribichini, F., Gambaro, A., Pighi, M., Pesarini, G., Ferraro, P. M., Zuppi, C., Baroni, S., Penitente, R., Ferrero, V. and Vassanelli, C.
Title: Effects of prednisone on biomarkers of tubular damage induced by radiocontrast in interventional cardiology
Journal: J Nephrol
Short Title: Effects of prednisone on biomarkers of tubular damage induced by radiocontrast in interventional cardiology
Alternate Journal: Journal of nephrology
ISSN: 1724-6059 (Electronic)
Accession Number: 23543480
Cardiac Imaging Techniques/*methods
Contrast Media/*adverse effects
Kidney Diseases/blood/*chemically induced/*prevention & control/urine
Kidney Tubules/*drug effects
Abstract: BACKGROUND: Contrast-induced nephropathy (CI-AKI) is a complication of diagnostic/therapeutic hemodynamic procedures in cardiology, which may also cause renal cholesterolinic atheroembolism. Despite the severe clinical impact of these complications, there is no optimal therapy for preventing and treating them. We suggest a short course of high-dose steroids as an effective preventive measure. METHODS: Patients at risk of CI-AKI (n = 38) undergoing cardiovascular procedures were assigned 1:1 to 1 of 2 experimental arms (prednisone+hydration vs. hydration alone). Oral prednisone 1 mg/kg was administered 12 hours before, at 6 am on the same day, and 24 hours following the procedure. Serum creatinine was tested immediately before and again 24-48 hours after the procedure; neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), protein and albumin were assayed in spot urine before and 6 hours after the procedure. RESULTS: NGAL and KIM-1 tended to rise after the procedure, but to a lesser degree in the prednisone group (delta NGAL: hydration = +128%, prednisone = +46%; p = 0.26; delta KIM-1: hydration = +99%, prednisone = +11%; p = 0.02). Proteinuria and albuminuria decreased significantly in the prednisone group. In 5 patients developing CI-AKI, their delta NGAL and delta KIM-1 did not differ from the values seen in patients without CI-AKI. Hypertension, peripheral arteriopathy and use of low-dose aspirin or diuretics were positive predictors of baseline NGAL, while treatment with calcium channel blockers and statins were negative predictors. Statins were negative predictors of baseline KIM-1. CONCLUSIONS: A short course of prednisone reduces the procedure-induced changes in biomarkers of renal tubular damage. This study suggests that steroids had a tubule-protecting effect.