Brain natriuretic peptide for prevention of contrast-inducednephropathy: a meta-analysis of randomized controlled trials
Contrast-induced nephropathy (CIN) is a serious complication and associated with poor clinical outcomes. The protective value of brain natriuretic peptide (BNP) administration on CIN is still controversial in patients undergoing percutaneous coronary intervention (PCI) or coronary angiography (CAG). We performed a meta-analysis of randomized controlled trials (RCTs) for BNP in preventing CIN.
We systematically searched PubMed, Web of Science, Cochrane Library, and ClinicalTrials.gov for RCTs comparing administration of BNP versus non-BNP for preventing CIN. Publication bias was assessed by funnel plots. Relative risk (RR) was calculated for incidence of CIN and major adverse cardiovascular events (MACEs) using the random or fixed effect model according to heterogeneity analysis.
There were five RCTs with 1441 patients in this analysis. BNP treatment was associated with lower incidence of CIN (RR = 0.38, 95 % CI 0.27–0.54, p < 0.001) and MACEs (RR = 0.47, 95 % CI 0.24–0.95, p = 0.034) with no significant heterogeneity (I2 = 0 %, p = 0.701; I2 = 60 %, p = 0.113, respectively). Similar results were seen in subgroup analysis. Prophylactic BNP significantly decreased the incidence of CIN after cardiac catheterization in the studies of regarding sodium chloride as placebo (I2 = 0 %, RR = 0.39, 95 % CI 0.27–0.56, p < 0.001) or JADAD score > 3 (I2 = 0 %, RR = 0.38, 95 % CI 0.21–0.68, p = 0.001).
Preprocedural BNP treatment significantly decreased the incidence of CIN and short-term MACEs in patients undergoing PCI or CAG.
KeywordsBrain natriuretic peptide Contrast-induced nephropathy Meta-analysis Percutaneous coronary intervention Coronary angiography
The authors thank Hong-yuan Xia (Department of Cardiology, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China) for providing the data on the incidence of CIN.
Yh L was responsible for the conception of the work. Xb W, LJ, and Xr L contributed to study search and selection. Pc H carried out the statistical analyses. Xb W wrote the manuscript. Pc H and Yh L were responsible for revision of the article. All authors edited the manuscript and approved the final version.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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