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Preventive Effect of Pretreatment with Intravenous Nicorandil on Contrast-Induced Nephropathy in Patients with Renal Dysfunction Undergoing Coronary Angiography (PRINCIPLE Study)

 Young-Guk Ko  ;  Byoung-Kwon Lee  ;  Woong Chol Kang  ;  Jae-Youn Moon  ;  Yun Hyeong Cho  ;  Seong Hun Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang  ;  Jong-Youn Kim  ;  Pil-Ki Min  ;  Hyuck-Moon Kwon 
 YONSEI MEDICAL JOURNAL, Vol.54(4) : 957-964, 2013 
Journal Title
Issue Date
Administration, Intravenous ; Aged ; Contrast Media/adverse effects* ; Coronary Angiography/adverse effects* ; Coronary Angiography/methods ; Creatinine/blood ; Female ; Glomerular Filtration Rate ; Humans ; Incidence ; Kidney Diseases/chemically induced* ; Kidney Diseases/epidemiology ; Kidney Diseases/physiopathology ; Kidney Diseases/prevention & control* ; Male ; Middle Aged ; Nicorandil/administration & dosage* ; Nicorandil/therapeutic use
Contrast media ; acute kidney injury ; coronary artery disease
PURPOSE: To investigate the effect of pretreatment with intravenous nicorandil on the incidence of contrast-induced nephropathy (CIN) in patients with renal dysfunction undergoing coronary angiography. MATERIALS AND METHODS: This randomized controlled multicenter study enrolled a total of 166 patients (nicorandil n=81; control n=85) with an estimated glomerular filtration rate <60 mL/min. Nicorandil 12 mg dissolved in 100 mL of 0.9% saline was administered intravenously for 30 minutes just prior to coronary angiography in the nicorandil group. The same volume of only saline was given to the control group. The primary endpoint was the incidence of CIN, defined as >0.5 mg/dL increase or >25% rise in serum creatinine (SCr) concentration within 48 hours of contrast exposure compared to baseline. RESULTS: The final analysis included 149 patients (nicorandil n=73; control n=76). The baseline characteristics and the total volume of the used contrast (Iodixanol, 125.6±69.1 mL vs. 126.9±74.6 mL, p=0.916) were similar between the two groups. The incidence of CIN also did not differ between the nicorandil and control groups (6.8% vs. 6.6%, p=0.794). There was no difference between the two groups in the relative change in SCr from baseline to peak level within 48 hours after coronary angiography (-1.58±24.07% vs. 0.96±17.49%, p=0.464), although the nicorandil group showed less absolute change in SCr than the control group (-0.01±0.43 mg/mL vs. 0.02±0.31 mg/mL, p=0.005). CONCLUSION: Prophylactic intravenous infusion of nicorandil did not decrease the incidence of CIN in patients with renal dysfunction undergoing coronary angiography.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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