scholarly journals Preventive Effect of Shenduning Prescription Combined with Hydration Therapy on Contrast Induced Nephronpathy after Elective Percutaneous Coronary Intervention

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Jiangang Jiang ◽  
Xianqing Hu ◽  
Ningning Ji ◽  
Chengyuan Yan ◽  
Jingliang Lan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Statistical Significance ◽  
Coronary Intervention ◽  
Interventional Therapy ◽  
Preventive Effect ◽  
Atorvastatin Calcium ◽  
Statin Group ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Hydration Therapy

Objective — To explore the preventive effect of Shenduning prescription combined with hydration therapy on contrast induced nephronpathy (CIN) after elective percutaneous coronary intervention. Methods — 159 patients undergoing selective coronary intervention were divided into simple hydration group, intensive statin group and Shenduning prescription group randomly, with 53 cases in each group. The simple hydration group received conventional drugs for coronary heart disease and preoperative routine hydration therapy. The intensive statin group received intensive treatment with atorvastatin calcium tablets on the basis of the simple hydration group, and the Shenduning prescription group received Shenduning prescription treatment on the basis of the hydration group. Serum creatinine (Scr), malondialdehyde (MDA), superoxide dismutase (SOD) and glomerular filtration rate (eGFR) were detected by blood samples at 24h before and after operation, as well as 72h after operation respectively. The primary endpoint event was the occurrence of CI-AKI. Results — The Scr level of the intensive statin group and the Shenduning prescription group was significantly lower than that of the simple hydration group, while the eGFR level was significantly higher than that of the simple hydration group, which is of statistical significance (P<0.05). The incidence of CI-AKI was 15.1% in simple hydration group, 5.7% in intensive statin group and 3.8% in Shenduning prescription group respectively after operation (χ2 = 5.194, P=0.075), of which there was significant statistical difference between simple hydration group and Shenduning prescription group (χ2 = 3.975, P=0.046). After 72h of the operation, MDA level in Shenduning prescription group was significantly lower than that in simple hydration group and intensive statin group, while its SOD level was significantly higher than that in simple hydration group and intensive statin group, which is of statistical significance (P<0.05). The proportion of abnormal liver function in intensive statin group and the Shenduning prescription group was 13.1% and 3.8%, respectively, and the difference was statistically significant (χ2 = 4.867, P=0.027). Conclusion — The combination treatment of Shenduning prescription with hydration therapy may protect the patient’s renal function after elective coronary interventional therapy, while reducing the incidence of CIN and the oxidative stress reaction caused by contrast agent, thus effectively reducing adverse reactions.

scholarly journals Omega-3 Supplementation in the Prevention of Contrast Induced Nephropathy in Patients Undergoing Elective Percutaneous Coronary Intervention: A Randomized Placebo-Controlled Trial

2019 ◽  
Vol 9 (2) ◽  
pp. 307-313 ◽  
Author(s):  
Farzaneh Foroughinia ◽  
Mahtabalsadat Mirjalili ◽  
Ehsan Mirzaei ◽  
Alireza Oboodi
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cystatin C ◽  
Coronary Intervention ◽  
Protective Role ◽  
Control Group ◽  
Omega 3 ◽  
Contrast Induced Nephropathy ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Hydration Therapy

Purpose: Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired renal failure and is associated with significant morbidity and mortality. Several studies have revealed the protective role of omega-3 in prevention and treatment of some kidney injuries. This study was conducted to examine the effect of omega-3 supplementation on the markers of renal function and to evaluate its potential in the prevention of CIN in patients undergoing elective percutaneous coronary intervention (PCI). Methods: In this double-blind, randomized clinical trial, 85 eligible patients scheduled for PCI was randomly divided into omega-3 (a single 3750 mg dose of omega-3 as well as routine hydration therapy within 12 hours before PCI) or control (placebo plus routine hydration therapy) groups. Serum creatinine (SCr) and cystatin C levels were measured at baseline and 24 hours after PCI. Results: Our results indicated that post- PCI cystatin C levels were significantly decreased in the omega-3 group compared to the control group (P < 0.001). Although less upward manner was seen in the level of 24-hour creatinine in the omega-3 group, it did not reach the significance level (P = 0.008). Conclusion: The positive effect of omega-3 on cystatin C levels showed that it may have a protective role in the prevention of CIN in post-PCI patients with normal kidney function. However, to better assess this effect, it is highly recommended to design future studies with higher doses and longer duration of therapy with omega-3 plus long-term follow up.

scholarly journals Effect of CYP3A4*22 and PPAR-α Genetic Variants on Platelet Reactivity in Patients Treated with Clopidogrel and Lipid-Lowering Drugs Undergoing Elective Percutaneous Coronary Intervention

Genes ◽  
2020 ◽  
Vol 11 (9) ◽  
pp. 1068
Author(s):  
Thomas Bergmeijer ◽  
Alfi Yasmina ◽  
Gerrit Vos ◽  
Paul Janssen ◽  
Christian Hackeng ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Genetic Variants ◽  
Platelet Reactivity ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Study Cohort ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary

This study aims to determine whether genetic variants that influence CYP3A4 expression are associated with platelet reactivity in clopidogrel-treated patients undergoing elective percutaneous coronary intervention (PCI), and to evaluate the influence of statin/fibrate co-medication on these associations. A study cohort was used containing 1124 consecutive elective PCI patients in whom CYP3A4*22 and PPAR-α (G209A and A208G) SNPs were genotyped and the VerifyNow P2Y12 platelet reactivity test was performed. Minor allele frequencies were 0.4% for CYP3A4*22/*22, 6.8% for PPAR-α G209A AA, and 7.0% for PPAR-α A208G GG. CYP3A4*22 was not associated with platelet reactivity. The PPAR-α genetic variants were significantly associated with platelet reactivity (G209A AA: −24.6 PRU [−44.7, −4.6], p = 0.016; A208G GG: −24.6 PRU [−44.3, −4.8], p = 0.015). Validation of these PPAR-α results in two external cohorts, containing 716 and 882 patients, respectively, showed the same direction of effect, although not statistically significant. Subsequently, meta-analysis of all three cohorts showed statistical significance of both variants in statin/fibrate users (p = 0.04 for PPAR-a G209A and p = 0.03 for A208G), with no difference in statin/fibrate non-users. In conclusion, PPAR-α G209A and A208G were associated with lower platelet reactivity in patients undergoing elective PCI who were treated with clopidogrel and statin/fibrate co-medication. Further research is necessary to confirm these findings.

Percutaneous Coronary Intervention in Patients with Diabetes and Multivessel or Left Main Disease – a Review

2012 ◽  
Vol 7 (1) ◽  
pp. 37
Author(s):  
Donald E Cutlip ◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Statistical Significance ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Metal Stents ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
The Impact

Coronary artery disease in patients with diabetes is frequently a diffuse process with multivessel involvement and is associated with increased risk for myocardial infarction and death. The role of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and multivessel disease who require revascularisation has been debated and remains uncertain. The debate has been continued mainly because of the question to what degree an increased risk for in-stent restenosis among patients with diabetes contributes to other late adverse outcomes. This article reviews outcomes from early trials of balloon angioplasty versus CABG through later trials of bare-metal stents versus CABG and more recent data with drug-eluting stents as the comparator. Although not all studies have been powered to show statistical significance, the results have been generally consistent with a mortality benefit for CABG versus PCI, despite differential risks for restenosis with the various PCI approaches. The review also considers the impact of mammary artery grafting of the left anterior descending artery and individual case selection on these results, and proposes an algorithm for selection of patients in whom PCI remains a reasonable strategy.

Sign in / Sign up

Export Citation Format

Share Document