Abstract
INTRODUCTION: Contrast-induced nephropathy (CIN) is a feared complication of angiographic procedures, resulting in a sudden decline in renal function. METHODS: PubMed, ScienceDirect, and Google Scholar were searched for potentially relevant articles from inception till August 2024. The meta-analysis was conducted using RevMan 5.4 with risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) computed. RESULTS: Ultimately, 13 studies were incorporated in the analysis. Nicorandil portrayed a significant protective effect against CIN (RR: 0.42; 95% CI: 0.33-0.54; p < 0.00001). Subgroup analysis revealed the superiority of the oral administration (RR: 0.38; 95% CI: 0.28-0.50; p < 0.00001). Nicorandil was also effective in reducing CIN in renal dysfunction patients (RR: 0.40; 95% CI: 0.27-0.59; p < 0.00001). Blood urea nitrogen (BUN) and cystatin-C 48-hours post-procedure (MD: -0.42; 95% CI: -0.53--0.30; p < 0.00001 and MD: -0.27; 95% CI: -0.51--0.02; p = 0.03, respectively) were superior in the nicorandil cohort. Serum creatinine was significantly lower in patients receiving nicorandil at 24- and 72-hour intervals (MD: -3.18, MD: -4.26, and MD: -3.75, respectively). There were no increased risks of adverse events in the nicorandil cohort. CONCLUSION: Nicorandil has promising efficacy and safety in reducing the risk of CIN. However, further trials are necessary in order to validate our conclusions.