Abstract
Contrast-induced acute kidney injury (CI-AKI) is one of the leading causes of acute kidney injury. Trimetazidine (TMZ) is a type of anti-ischemic drug developed in recent year. Available data on the renal effects showed TMZ can significantly reduce the incidence of (CI-AKI). We conducted this systematic review and meta-analysis of clinical trials that investigated the clinical effect of TMZ on the prevention of CIN in patients with renal insufficiency patients undergoing percutaneous coronary intervention. This meta-analysis was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). A search of the Medline, Cochrane and Google Scholar databases were conducted independently by two researchers for randomized controlled trials comparing TMZ versus conventional hydration alone for the prevention of CIN. The relative risk (RR) was estimated with a 95% confidence interval (CI). Heterogeneity was reported with the I2 statistic, using a fixed-effects model, and >50% of I2 was considered to be statistically significant. All statistical analyses were performed using STATA software, version 12.0. 11 studies met our inclusion/exclusion criteria including 1611 patients: 797 undergoing TMZ plus hydration and 814 controls (hydration only). Heterogeneity of each study was low, I2 = 0%, P = 0.747. The incidence of CIN in the TMZ plus hydration group was 6.0% (48/797) and the incidence of CIN in the control (hydration) group was 20.6% (168/814). A pooled analysis for all studies showed that TMZ can significantly reduce the incidence of CIN AKI compared to saline alone (relative risk 0.35, 95% confidence interval [CI] 0.25, 0.48, P = 0.000). Present systematic review and meta-analysis by combining data from 11 studies showed Trimetazidine can effectively protect renal function and reducing the incidence of CIN in patients undergoing coronary angiography.
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