Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional
BackgroundContrast-induced nephropathy (CIN) is one of the most common complications after coronary stent implantation due to the extensive development of coronary catheterization technology. Compound Danshen dripping pills (CDDP) are clinically used as cardiovascular drugs, relieving systemic infla...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1211982/full |
| _version_ | 1797402900735983616 |
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| author | Han Fu Han Fu Linrui Wang Shuo Ying Zhicheng Zhao Peng Zhang |
| author_facet | Han Fu Han Fu Linrui Wang Shuo Ying Zhicheng Zhao Peng Zhang |
| author_sort | Han Fu |
| collection | DOAJ |
| description | BackgroundContrast-induced nephropathy (CIN) is one of the most common complications after coronary stent implantation due to the extensive development of coronary catheterization technology. Compound Danshen dripping pills (CDDP) are clinically used as cardiovascular drugs, relieving systemic inflammatory response. Previous studies have observed that CDDP can decrease CIN incidence after coronary stent implantation with uncertain effectiveness.MethodsWe conducted a prospective, randomized, single-center, single-blind, controlled trial. We enrolled patients 18 years and older with unstable angina pectoris and NSTEMI who underwent PCI at the Tianjin Chest Hospital between November 1, 2021, and November 31, 2022, and followed for 30 days. Patients were randomized to CDDP and hydration therapy (10 capsules three times/day; N = 411) or hydration only (N = 411). The primary outcome was the contrast nephropathy incidence, defined as an elevation in serum creatinine by more than 25% or 44 μmol/L from baseline within 48–72 h of contrast exposure. Secondary outcomes included major adverse cardiovascular events post-surgery and during follow-up.ResultsAfter 48 h of operation, the two groups had statistical significance in Scr and BUN values (80.0 ± 12.59 vs. 84.43 ± 13.49, P < 0.05; 6.22 ± 1.01 vs. 6.40 ± 0.93, P < 0.05). The difference in Scr in 72 h between the two groups was statistically significant (76.42 ± 10.92 vs. 79.06 ± 11.58, P < 0.05). The CIN incidence was significantly lower in the CDDP group than in the hydration group. The CIN risk was significantly elevated in patients with LVEF <50%, contrast volume ≥160 ml, and hypertension, after 48 and 72 h of operation. The serum inflammation index levels NGAL, TNF-α, oxidative stress indexes SOD, and MDA significantly differed between the two groups. However, there was no significant difference in serum apoptosis indexes Bax, Bcl-2, and Casepase-9.ConclusionsCDDP pre-treatment could prevent contrast-induced nephropathy. Inflammatory response and oxidative stress could be significant in the CDDP mechanism. |
| first_indexed | 2024-03-09T02:30:49Z |
| format | Article |
| id | doaj.art-a83f8be499eb4769a45b0fdbb9d5d6f3 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-09T02:30:49Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-a83f8be499eb4769a45b0fdbb9d5d6f32023-12-06T13:40:40ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-12-011010.3389/fcvm.2023.12119821211982Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventionalHan Fu0Han Fu1Linrui Wang2Shuo Ying3Zhicheng Zhao4Peng Zhang5Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaGraduate School of Tianjin Medical University, Tianjin, ChinaSheng Jing Hospital Affiliated, China Medical University, Shenyang, ChinaDepartment of Cardiology, Tianjin Chest Hospital, Tianjin University, Tianjin, ChinaGraduate School of Tianjin Medical University, Tianjin, ChinaDepartment of Cardiology, Tianjin Chest Hospital, Tianjin University, Tianjin, ChinaBackgroundContrast-induced nephropathy (CIN) is one of the most common complications after coronary stent implantation due to the extensive development of coronary catheterization technology. Compound Danshen dripping pills (CDDP) are clinically used as cardiovascular drugs, relieving systemic inflammatory response. Previous studies have observed that CDDP can decrease CIN incidence after coronary stent implantation with uncertain effectiveness.MethodsWe conducted a prospective, randomized, single-center, single-blind, controlled trial. We enrolled patients 18 years and older with unstable angina pectoris and NSTEMI who underwent PCI at the Tianjin Chest Hospital between November 1, 2021, and November 31, 2022, and followed for 30 days. Patients were randomized to CDDP and hydration therapy (10 capsules three times/day; N = 411) or hydration only (N = 411). The primary outcome was the contrast nephropathy incidence, defined as an elevation in serum creatinine by more than 25% or 44 μmol/L from baseline within 48–72 h of contrast exposure. Secondary outcomes included major adverse cardiovascular events post-surgery and during follow-up.ResultsAfter 48 h of operation, the two groups had statistical significance in Scr and BUN values (80.0 ± 12.59 vs. 84.43 ± 13.49, P < 0.05; 6.22 ± 1.01 vs. 6.40 ± 0.93, P < 0.05). The difference in Scr in 72 h between the two groups was statistically significant (76.42 ± 10.92 vs. 79.06 ± 11.58, P < 0.05). The CIN incidence was significantly lower in the CDDP group than in the hydration group. The CIN risk was significantly elevated in patients with LVEF <50%, contrast volume ≥160 ml, and hypertension, after 48 and 72 h of operation. The serum inflammation index levels NGAL, TNF-α, oxidative stress indexes SOD, and MDA significantly differed between the two groups. However, there was no significant difference in serum apoptosis indexes Bax, Bcl-2, and Casepase-9.ConclusionsCDDP pre-treatment could prevent contrast-induced nephropathy. Inflammatory response and oxidative stress could be significant in the CDDP mechanism.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1211982/fullcompound Danshen dripping pillscontrast-induced nephropathyinflammationoxidative stresspercutaneous coronary interventionprevention |
| spellingShingle | Han Fu Han Fu Linrui Wang Shuo Ying Zhicheng Zhao Peng Zhang Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional Frontiers in Cardiovascular Medicine compound Danshen dripping pills contrast-induced nephropathy inflammation oxidative stress percutaneous coronary intervention prevention |
| title | Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional |
| title_full | Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional |
| title_fullStr | Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional |
| title_full_unstemmed | Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional |
| title_short | Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional |
| title_sort | preventive effect and mechanism of compound danshen dripping pills on contrast induced nephropathy after percutaneous coronary interventional |
| topic | compound Danshen dripping pills contrast-induced nephropathy inflammation oxidative stress percutaneous coronary intervention prevention |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1211982/full |
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