Abstract
Purpose: Studies have revealed that patients with chronic kidney disease (CKD) are more susceptible to adverse effects of percutaneous coronary intervention (PCI). In addition, the role of elevated high sensitive C-reactive protein (hs-CRP) in the prediction of adverse cardiac outcomes after coronary stent implantation has already been shown. Therefore, in this study, we aimed to evaluate the effect of omega-3 supplementation on hs-CRP and 30-day major adverse cardiac events (MACE) in patients with CKD undergoing elective PCI.Methods: In this randomized trial, 80 CKD patients who were candidates for elective PCI, were randomly assigned to two groups; the first group received a single dose of omega-3 (2500 mg, 12 h before PCI) as well as the standard drug regimen of PCI and the second group received placebo plus the standard therapy (325 mg loading dose of aspirin, 600 mg loading dose of clopidogrel, and weight-adjusted intravenous heparin). Hs-CRP levels were measured at baseline and 24 h after the intervention as a primary endpoint. The secondary endpoint was the incidence of MACE over a 30-day period after PCI.Results: Omega-3 did not significantly decrease post-PCI serum level of hs-CRP; however, the overall 30-day MACE was significantly lower in the omega-3 group compared to the control group (p=0.05).Conclusion: Our results revealed the positive effect of the omega-3 supplement on decreasing 30-day MACE; hence, omega-3 may be considered as an effective adjunctive therapy to the standard drug regimen used before PCI. The evaluation of the effect of omega-3 on long-term MACE is recommended for future studies.
Highlights
Today, coronary artery diseases are the main cause of death in patients with chronic kidney disease (CKD), and it is estimated that the mortality rate of these patients can be as high as 59% in the first year following a myocardial infarction
In this study, we aimed to evaluate the effect of omega-3 supplementation on high sensitive C-reactive protein (hs-CRP) and 30day major adverse cardiac events (MACE) in patients with CKD undergoing elective percutaneous coronary intervention (PCI)
Our results revealed the positive effect of the omega-3 supplement on decreasing 30-day MACE; omega-3 may be considered as an effective adjunctive therapy to the standard drug regimen used before PCI
Summary
Coronary artery diseases are the main cause of death in patients with chronic kidney disease (CKD), and it is estimated that the mortality rate of these patients can be as high as 59% in the first year following a myocardial infarction. CKD patients are more likely suffer from cardiac diseases and are at higher risk of experiencing severe adverse cardiac events.[1] recent studies indicate that CKD patients undergoing percutaneous coronary intervention (PCI) are more susceptible to various adverse effects such as intervention failure, longer length of stay in hospitals, and higher mortality after PCI.[2] The prognostic value of cardiac necrosis markers, troponins and creatine kinase-MB, in the prediction of complications of PCI, has been described extensively in the literature. ; it is recommended to use these values as a marker of baseline risk, atherosclerosis burden, and procedural complications in the setting of coronary re-vascularization.[3] On the other hand; several studies have indicated the key role of inflammation in the pathogenesis of atherosclerosis and its progression. Several studies have demonstrated the potential role of elevated hs-CRP in the prediction of both early and late adverse cardiac outcomes after coronary stent implantation.[4,5] serum hs-CRP level has been shown to be a strong
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