European Journal of Clinical Pharmacology

, Volume 72, Issue 11, pp 1311–1318 | Cite as

Brain natriuretic peptide for prevention of contrast-inducednephropathy: a meta-analysis of randomized controlled trials

  • Xue-biao Wei
  • Lei Jiang
  • Xin-rong Liu
  • Dan-qing Yu
  • Ning Tan
  • Ji-yan Chen
  • Ying-ling Zhou
  • Peng-cheng He
  • Yuan-hui Liu
Pharmacodynamics

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

Preprocedural BNP treatment significantly decreased the incidence of CIN and short-term MACEs in patients undergoing PCI or CAG.

Keywords

Brain natriuretic peptide Contrast-induced nephropathy Meta-analysis Percutaneous coronary intervention Coronary angiography 

Notes

Acknowledgments

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.

Author contributions

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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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Xue-biao Wei
    • 1
  • Lei Jiang
    • 1
  • Xin-rong Liu
    • 1
  • Dan-qing Yu
    • 1
  • Ning Tan
    • 1
  • Ji-yan Chen
    • 1
  • Ying-ling Zhou
    • 1
  • Peng-cheng He
    • 1
  • Yuan-hui Liu
    • 1
  1. 1.Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouChina

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