Clinical InvestigationCoronary Artery DiseasePrevention of radiocontrast medium–induced nephropathy using short-term high-dose simvastatin in patients with renal insufficiency undergoing coronary angiography (PROMISS) trial—a randomized controlled study
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Study population
The PROMISS trial was conducted in 2 national hospitals in Korea: Seoul National University Hospital, Seoul, Korea, and Seoul National University Bundang Hospital, Gyeonggi-do, Korea. A total of 3080 patients referred for coronary catheterization and/or coronary intervention were screened for eligibility from February 2005 through January 2006. Patients aged ≥19 years with creatinine clearance (CrCl) rates ≤60 mL/min (calculated using the Cockcroft-Gault formula)18 or baseline serum creatinine
Patient population and baseline characteristics
Between February 2005 and January 2006, a total of 3080 consecutive patients were screened. Among them, 490 patients with a basal CrCl ≤60 mL/min and/or a SCr ≥1.1 mg/dL were considered eligible for participation. Eight patients declined participation, 2 were excluded because of chronic dialysis, and 233 were excluded because they were on statin medication. Thus, 247 patients were randomized, 124 to receive simvastatin and 123 to receive placebo, and included in the intention-to-treat analyses (
Contrast-induced nephropathy prevention by antioxidants
Oxidative stress is considered an important mechanism in the development of CIN, based on evidence indicating a role for reactive oxygen species in contrast-mediated renal injury.6, 7 The antioxidant NAC has been investigated extensively as an agent for CIN prevention. Representative findings have demonstrated an increased benefit of NAC added to prophylactic hydration alone7 and, more recently, greater efficacy with increased NAC dosing (1200 vs 600 mg, twice daily),21 consistent with the
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Update and review of contrast-associated acute kidney injury
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2021, Nephrologie et TherapeutiqueA Practical Approach to Preventing Renal Complications in the Catheterization Laboratory
2020, Interventional Cardiology ClinicsNephrotoxicity of iodinated contrast media: From pathophysiology to prevention strategies
2019, European Journal of Radiology
Clinical Trial Registration: www.ClinicalTrials.gov; Identifier: NCT00259441.
This study was supported by a grant from the Innovative Research Institute for Cell Therapy, Department of Internal Medicine, Seoul National University/Cardiovascular Center, (A062260) and the Clinical Research Center for Ischemic Heart Disease, Seoul, Republic of Korea, (0412-CR02-0704-0001) sponsored by the Ministry of Health & Welfare, Republic of Korea.
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The affiliation of the author has changed from Seoul National University Hospital to Hallym University Sacred Heart Hospital since this work was completed.