Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials
Background Contrast‐induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). We aimed to assess the latest evidence on the effect of remote ischemic preconditioning (RIPC) on the inc...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2020-11, Vol.96 (6), p.1200-1212 |
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| creator | Pranata, Raymond Tondas, Alexander E. Vania, Rachel Toruan, Mangiring P. L. Lukito, Antonia A. Siswanto, Bambang B. |
| description | Background
Contrast‐induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). We aimed to assess the latest evidence on the effect of remote ischemic preconditioning (RIPC) on the incidence of CIN in patients undergoing CAG/PCI.
Methods
We performed a comprehensive search on topics assessing RIPC and CIN in CAG/PCI patients from inception up until July 2019 through several electronic databases.
Results
There were a total of 1,925 subjects from 14 randomized controlled trials. Remote ischemic preconditioning was associated with reduced CIN incidence in patients undergoing CAG/PCI (OR 0.41 [0.30, 0.55], p |
| doi_str_mv | 10.1002/ccd.28709 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2334698240</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2334698240</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-e6717488d87222da63c66475fa478d4609fd065bf8c10270ba05b3f6ec9bd5883</originalsourceid><addsrcrecordid>eNp1kU2O1DAQhSMEYoaBBRdAltjAoqcdx3FsdqPmVxoJiR-JXeTYlW6PEjvYzozCiiNwO_achOrphgUSqypZn9-rqlcUj0t6XlLK1sbYcyYbqu4Up2XN2Kph4svdY18qLk6KByldUUqVYOp-cVKVqmRKidPi5wcYQwbiktnB6AyZIpjgrcsueOe3JIKdDSSSdwh54yx4AyT0BKkcdcq_vv9wfs9Y4mHaxTDpvFuQJdg48DmR2VuI27CXMyEGr-NCtN-6sI162i1r5zPEa0TR8wX5uKQMI_41aH7t4AZZS0bIGq2018OSXNpPEPE9jO4bOt8OE4YB2xydHtLD4l6PBR4d61nx-fWrT5u3q8v3b95tLi5XpqortQLRlA2X0sqGMWa1qIwQvKl7zRtpuaCqt1TUXS9NSVlDO03rruoFGNXZWsrqrHh20J1i-DpDyu2Ip4Rh0B7CnFpWVVwoyThF9Ok_6FWYI-6DFBeM17KuOVLPD5SJIaUIfTtFN-LF2pK2-7RbTLu9TRvZJ0fFuRvB_iX_xIvA-gDcuAGW_yu1m83Lg-Rvwu68gw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2462458554</pqid></control><display><type>article</type><title>Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Pranata, Raymond ; Tondas, Alexander E. ; Vania, Rachel ; Toruan, Mangiring P. L. ; Lukito, Antonia A. ; Siswanto, Bambang B.</creator><creatorcontrib>Pranata, Raymond ; Tondas, Alexander E. ; Vania, Rachel ; Toruan, Mangiring P. L. ; Lukito, Antonia A. ; Siswanto, Bambang B.</creatorcontrib><description>Background
Contrast‐induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). We aimed to assess the latest evidence on the effect of remote ischemic preconditioning (RIPC) on the incidence of CIN in patients undergoing CAG/PCI.
Methods
We performed a comprehensive search on topics assessing RIPC and CIN in CAG/PCI patients from inception up until July 2019 through several electronic databases.
Results
There were a total of 1,925 subjects from 14 randomized controlled trials. Remote ischemic preconditioning was associated with reduced CIN incidence in patients undergoing CAG/PCI (OR 0.41 [0.30, 0.55], p < .001; I2: 22%). The nephroprotective effect was also demonstrated in those at moderate‐high risk for CIN subgroup (OR 0.41 [0.29, 0.58], p < .001; I2: 26%) and PCI‐only subgroup (OR 0.41 [0.29, 0.58], p < .001; I2: 0%). Time from RIPC to CAG/PCI has similar effectiveness among ≤45, ≤60, and ≤120 min. Mortality, rehospitalization, hemodialysis, and major adverse events were lower in the RIPC group (OR 0.50 [0.33, 0.76], p = .001; I2: 0%). Grading of recommendations assessment, development and evaluation (GRADE) assessment showed that RIPC has high evidence certainty for reducing CIN in patients undergoing PCI/CAG, moderate‐high risk subgroup, and PCI‐only subgroup with absolute reduction of 97 per 1,000, 129 per 1,000, and 121 per 1,000, respectively. Harbord test showed no evidence for the presence of small‐study effects (p = .157).
Conclusions
Remote ischemic preconditioning is an effective procedure to reduce the risk of CIN and should be considered in patients with moderate‐high risk at developing CIN.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.28709</identifier><identifier>PMID: 31912996</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Angiography ; Clinical trials ; contrast‐induced nephropathy ; coronary angiography ; coronary artery disease ; Hemodialysis ; Ischemia ; Medical imaging ; Meta-analysis ; Morbidity ; Mortality ; Nephropathy ; percutaneous coronary intervention ; remote ischemic preconditioning ; Risk groups ; Trinucleotide repeats</subject><ispartof>Catheterization and cardiovascular interventions, 2020-11, Vol.96 (6), p.1200-1212</ispartof><rights>2020 Wiley Periodicals, Inc.</rights><rights>2020 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-e6717488d87222da63c66475fa478d4609fd065bf8c10270ba05b3f6ec9bd5883</citedby><cites>FETCH-LOGICAL-c3539-e6717488d87222da63c66475fa478d4609fd065bf8c10270ba05b3f6ec9bd5883</cites><orcidid>0000-0003-3998-1590 ; 0000-0001-8519-8949 ; 0000-0003-3998-6551 ; 0000-0002-4780-6592 ; 0000-0002-9556-3994 ; 0000-0002-2317-5212</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.28709$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.28709$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31912996$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pranata, Raymond</creatorcontrib><creatorcontrib>Tondas, Alexander E.</creatorcontrib><creatorcontrib>Vania, Rachel</creatorcontrib><creatorcontrib>Toruan, Mangiring P. L.</creatorcontrib><creatorcontrib>Lukito, Antonia A.</creatorcontrib><creatorcontrib>Siswanto, Bambang B.</creatorcontrib><title>Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Background
Contrast‐induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). We aimed to assess the latest evidence on the effect of remote ischemic preconditioning (RIPC) on the incidence of CIN in patients undergoing CAG/PCI.
Methods
We performed a comprehensive search on topics assessing RIPC and CIN in CAG/PCI patients from inception up until July 2019 through several electronic databases.
Results
There were a total of 1,925 subjects from 14 randomized controlled trials. Remote ischemic preconditioning was associated with reduced CIN incidence in patients undergoing CAG/PCI (OR 0.41 [0.30, 0.55], p < .001; I2: 22%). The nephroprotective effect was also demonstrated in those at moderate‐high risk for CIN subgroup (OR 0.41 [0.29, 0.58], p < .001; I2: 26%) and PCI‐only subgroup (OR 0.41 [0.29, 0.58], p < .001; I2: 0%). Time from RIPC to CAG/PCI has similar effectiveness among ≤45, ≤60, and ≤120 min. Mortality, rehospitalization, hemodialysis, and major adverse events were lower in the RIPC group (OR 0.50 [0.33, 0.76], p = .001; I2: 0%). Grading of recommendations assessment, development and evaluation (GRADE) assessment showed that RIPC has high evidence certainty for reducing CIN in patients undergoing PCI/CAG, moderate‐high risk subgroup, and PCI‐only subgroup with absolute reduction of 97 per 1,000, 129 per 1,000, and 121 per 1,000, respectively. Harbord test showed no evidence for the presence of small‐study effects (p = .157).
Conclusions
Remote ischemic preconditioning is an effective procedure to reduce the risk of CIN and should be considered in patients with moderate‐high risk at developing CIN.</description><subject>Angiography</subject><subject>Clinical trials</subject><subject>contrast‐induced nephropathy</subject><subject>coronary angiography</subject><subject>coronary artery disease</subject><subject>Hemodialysis</subject><subject>Ischemia</subject><subject>Medical imaging</subject><subject>Meta-analysis</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Nephropathy</subject><subject>percutaneous coronary intervention</subject><subject>remote ischemic preconditioning</subject><subject>Risk groups</subject><subject>Trinucleotide repeats</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kU2O1DAQhSMEYoaBBRdAltjAoqcdx3FsdqPmVxoJiR-JXeTYlW6PEjvYzozCiiNwO_achOrphgUSqypZn9-rqlcUj0t6XlLK1sbYcyYbqu4Up2XN2Kph4svdY18qLk6KByldUUqVYOp-cVKVqmRKidPi5wcYQwbiktnB6AyZIpjgrcsueOe3JIKdDSSSdwh54yx4AyT0BKkcdcq_vv9wfs9Y4mHaxTDpvFuQJdg48DmR2VuI27CXMyEGr-NCtN-6sI162i1r5zPEa0TR8wX5uKQMI_41aH7t4AZZS0bIGq2018OSXNpPEPE9jO4bOt8OE4YB2xydHtLD4l6PBR4d61nx-fWrT5u3q8v3b95tLi5XpqortQLRlA2X0sqGMWa1qIwQvKl7zRtpuaCqt1TUXS9NSVlDO03rruoFGNXZWsrqrHh20J1i-DpDyu2Ip4Rh0B7CnFpWVVwoyThF9Ok_6FWYI-6DFBeM17KuOVLPD5SJIaUIfTtFN-LF2pK2-7RbTLu9TRvZJ0fFuRvB_iX_xIvA-gDcuAGW_yu1m83Lg-Rvwu68gw</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Pranata, Raymond</creator><creator>Tondas, Alexander E.</creator><creator>Vania, Rachel</creator><creator>Toruan, Mangiring P. L.</creator><creator>Lukito, Antonia A.</creator><creator>Siswanto, Bambang B.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3998-1590</orcidid><orcidid>https://orcid.org/0000-0001-8519-8949</orcidid><orcidid>https://orcid.org/0000-0003-3998-6551</orcidid><orcidid>https://orcid.org/0000-0002-4780-6592</orcidid><orcidid>https://orcid.org/0000-0002-9556-3994</orcidid><orcidid>https://orcid.org/0000-0002-2317-5212</orcidid></search><sort><creationdate>202011</creationdate><title>Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials</title><author>Pranata, Raymond ; Tondas, Alexander E. ; Vania, Rachel ; Toruan, Mangiring P. L. ; Lukito, Antonia A. ; Siswanto, Bambang B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-e6717488d87222da63c66475fa478d4609fd065bf8c10270ba05b3f6ec9bd5883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Angiography</topic><topic>Clinical trials</topic><topic>contrast‐induced nephropathy</topic><topic>coronary angiography</topic><topic>coronary artery disease</topic><topic>Hemodialysis</topic><topic>Ischemia</topic><topic>Medical imaging</topic><topic>Meta-analysis</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Nephropathy</topic><topic>percutaneous coronary intervention</topic><topic>remote ischemic preconditioning</topic><topic>Risk groups</topic><topic>Trinucleotide repeats</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pranata, Raymond</creatorcontrib><creatorcontrib>Tondas, Alexander E.</creatorcontrib><creatorcontrib>Vania, Rachel</creatorcontrib><creatorcontrib>Toruan, Mangiring P. L.</creatorcontrib><creatorcontrib>Lukito, Antonia A.</creatorcontrib><creatorcontrib>Siswanto, Bambang B.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pranata, Raymond</au><au>Tondas, Alexander E.</au><au>Vania, Rachel</au><au>Toruan, Mangiring P. L.</au><au>Lukito, Antonia A.</au><au>Siswanto, Bambang B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2020-11</date><risdate>2020</risdate><volume>96</volume><issue>6</issue><spage>1200</spage><epage>1212</epage><pages>1200-1212</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Background
Contrast‐induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). We aimed to assess the latest evidence on the effect of remote ischemic preconditioning (RIPC) on the incidence of CIN in patients undergoing CAG/PCI.
Methods
We performed a comprehensive search on topics assessing RIPC and CIN in CAG/PCI patients from inception up until July 2019 through several electronic databases.
Results
There were a total of 1,925 subjects from 14 randomized controlled trials. Remote ischemic preconditioning was associated with reduced CIN incidence in patients undergoing CAG/PCI (OR 0.41 [0.30, 0.55], p < .001; I2: 22%). The nephroprotective effect was also demonstrated in those at moderate‐high risk for CIN subgroup (OR 0.41 [0.29, 0.58], p < .001; I2: 26%) and PCI‐only subgroup (OR 0.41 [0.29, 0.58], p < .001; I2: 0%). Time from RIPC to CAG/PCI has similar effectiveness among ≤45, ≤60, and ≤120 min. Mortality, rehospitalization, hemodialysis, and major adverse events were lower in the RIPC group (OR 0.50 [0.33, 0.76], p = .001; I2: 0%). Grading of recommendations assessment, development and evaluation (GRADE) assessment showed that RIPC has high evidence certainty for reducing CIN in patients undergoing PCI/CAG, moderate‐high risk subgroup, and PCI‐only subgroup with absolute reduction of 97 per 1,000, 129 per 1,000, and 121 per 1,000, respectively. Harbord test showed no evidence for the presence of small‐study effects (p = .157).
Conclusions
Remote ischemic preconditioning is an effective procedure to reduce the risk of CIN and should be considered in patients with moderate‐high risk at developing CIN.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31912996</pmid><doi>10.1002/ccd.28709</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-3998-1590</orcidid><orcidid>https://orcid.org/0000-0001-8519-8949</orcidid><orcidid>https://orcid.org/0000-0003-3998-6551</orcidid><orcidid>https://orcid.org/0000-0002-4780-6592</orcidid><orcidid>https://orcid.org/0000-0002-9556-3994</orcidid><orcidid>https://orcid.org/0000-0002-2317-5212</orcidid></addata></record> |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Angiography Clinical trials contrast‐induced nephropathy coronary angiography coronary artery disease Hemodialysis Ischemia Medical imaging Meta-analysis Morbidity Mortality Nephropathy percutaneous coronary intervention remote ischemic preconditioning Risk groups Trinucleotide repeats |
| title | Remote ischemic preconditioning reduces the incidence of contrast‐induced nephropathy in patients undergoing coronary angiography/intervention: Systematic review and meta‐analysis of randomized controlled trials |
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