Omega-3 Supplementation in the Prevention of Contrast Induced Nephropathy in Patients Undergoing Elective Percutaneous Coronary Intervention: A Randomized Placebo-Controlled Trial.

Farzaneh Foroughinia,Ehsan Mirzaei,Mahtabalsadat Mirjalili,Alireza Oboodi

doi:10.15171/apb.2019.036

Abstract

Purpose: Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired renal failure and is associated with significant morbidity and mortality. Several studies have revealed the protective role of omega-3 in prevention and treatment of some kidney injuries. This study was conducted to examine the effect of omega-3 supplementation on the markers of renal function and to evaluate its potential in the prevention of CIN in patients undergoing elective percutaneous coronary intervention (PCI). Methods: In this double-blind, randomized clinical trial, 85 eligible patients scheduled for PCI was randomly divided into omega-3 (a single 3750 mg dose of omega-3 as well as routine hydration therapy within 12 hours before PCI) or control (placebo plus routine hydration therapy) groups. Serum creatinine (SCr) and cystatin C levels were measured at baseline and 24 hours after PCI. Results: Our results indicated that post- PCI cystatin C levels were significantly decreased in the omega-3 group compared to the control group (P < 0.001). Although less upward manner was seen in the level of 24-hour creatinine in the omega-3 group, it did not reach the significance level (P = 0.008). Conclusion: The positive effect of omega-3 on cystatin C levels showed that it may have a protective role in the prevention of CIN in post-PCI patients with normal kidney function. However, to better assess this effect, it is highly recommended to design future studies with higher doses and longer duration of therapy with omega-3 plus long-term follow up.

Highlights

Today, contrast agents have been increasingly administered for diagnostic and therapeutic purposes
Our results indicated that post- percutaneous coronary intervention (PCI) cystatin C levels were significantly decreased in the omega-3 group compared to the control group (P < 0.001)
The positive effect of omega-3 on cystatin C levels showed that it may have a protective role in the prevention of Contrast-induced nephropathy (CIN) in post-PCI patients with normal kidney function

Summary

Introduction

Contrast agents have been increasingly administered for diagnostic and therapeutic purposes. Around 1%-2% of the general population and up to 50% of high-risk subgroups will experience this problem following coronary angiography (CA) or percutaneous coronary intervention (PCI).[3] The renal insufficiency caused by receiving contrast agents during PCI may increase the risk of subsequent cardiac events and mortality in a dose-dependent manner during and after PCI even in patients with normal renal function.[4,5] Nowadays, besides to serum creatinine (SCr), a new marker of renal function named cystatin C is used to assess renal status after PCI It is a more sensitive and superior marker than SCr in the detection of acute kidney injury in the early stages of renal dysfunction.[6]. We conducted this study to evaluate the efficacy of omega-3 supplementation in the prevention of CIN in patients undergoing elective PCI

Materials and Methods

Results and Discussion

Conclusion