Effects of angiotensin enzyme inhibitors and angiotensin receptor blockers therapy on contrast-induced nephropathy in patients undergoing PCI or CAG

Abstract:

Objective：To evaluate the effect of angiotensin enzyme inhibitors（ACEI） and angiotensin receptor blockers（ARB） therapy on contrast-induced nephropathy（CIN） in patients undergoing coronary angiogram（CAG） or percutaneous coronary intervention （PCI）. Methods：Search was conducted in PubMed，The Cochrane library，VIP，CNKI and Wanfang data for literatures about ACEI or ARB and CIN up to August 2014. According to the inclusion and exclusion criteria，articles were screened and data were extracted and quality of included studies was evaluated. Mata analysis was conducted by using Stata 11.0 software. Moreover，Begg’s and Egger’s regression were used to assess the publication bias of included articles. Results：Eleven studies were included. Among the patients un－dergoing PCI or CAG，the usage of ACEI/ARB before those operations did not increase the risk of CIN compared with that of control group，and there is no significant difference（RR=0.78；95%CI＝0.53 to 1.15，P=0.22）. In subgroup analysis，subgroups underwent ACEI/ARB treatment for at least 2 weeks（RR=0.78，95%CI＝0.37 to 1.62，P=0.50） and less than 2 weeks（RR=0.79，95%CI=0.50 to 1.24，P=0.30） had no influence on the incidence of CIN. The risk of CIN at 72 h after coronary intervention therapy was decreased（RR=0.23，95%CI=0.23 to 0.87，P=0.02） and the subgroup with contrast agent≤150ml showed a decreasing incidence of CIN（RR=0.57，95%CI=0.33 to 0.99，P=0.046）. Conclusion：There is no evi－dence to suggest that use of ACEI/ARB will increase the risk of CIN in patients undergoing PCI/CAG at present.