Furosemide's Preventative Role in Contrast-Induced Nephropathy among ST-Segment Elevation Myocardial Infarction Patients undergoing Percutaneous Coronary Intervention

呋塞米在经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者中预防造影剂肾病的作用

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Abstract

BACKGROUND: ST-elevation myocardial infarction (STEMI) is regarded as a risk factor for contrast-induced nephropathy (CIN). Numerous studies have explored preventive measures for CIN such as the use of diuretics. However, the specific impact of diuretics in averting nephropathy remains uncertain. We investigated whether post-treatment with furosemide decreases CIN risk. MATERIALS AND METHODS: We designed a clinical trial and included 234 patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Patients were divided into two groups: Group I (furosemide 0.5 mg/kg) and Group II (control). Serum creatinine and blood urea nitrogen (BUN) were measured pre- and post-surgery. CIN was described as more than either 25% or 0.5 mg/dL induction in serum creatinine from the baseline in 24 h and 72 h post-PCI. RESULTS: CIN occurred in 33 patients (14.1%) in 24 h and 35 patients (14.9%) in 72 h. CIN incidence was not significantly different between both groups. However, BUN was significantly higher in the furosemide group (P < 0.05). Most patients in the furosemide group were men and smokers compared to the control group. CONCLUSION: A combination of low-dose furosemide plus standard hydration was not correlated with lower CIN incidence in STEMI patients who are candidates for primary PCI compared to standard hydration only. Further studies with a larger sample size in the future are needed to better understand the effects of this combination.

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