Coronary artery diseaseComparison of Usefulness of Sodium Bicarbonate Versus Sodium Chloride to Prevent Contrast-Induced Nephropathy in Patients Undergoing an Emergent Coronary Procedure
Section snippets
Study population
Consecutive eligible patients undergoing an emergency diagnostic or interventional coronary procedure were considered for enrollment. The indication for an emergency coronary procedure was suspected acute coronary syndrome in all cases. Eligible patients included those ≥20 years of age with renal dysfunction, defined as serum creatinine concentration >1.1 mg/dl or estimated glomerular filtration rate (calculated by applying the Cockcroft-Gault formula) <60 ml/min, who were scheduled to undergo
Results
Between April 7, 2005 and June 3, 2006, 61 patients were initially enrolled in the study. However, 2 patients could not follow the study protocol and were excluded after randomization. One patient in the sodium bicarbonate group had circulatory failure with lactic acidosis requiring rapid infusion of sodium bicarbonate and another patient in the sodium chloride group underwent emergency mitral valve replacement surgery for acute mitral regurgitation as a complication of acute myocardial
Discussion
The major finding of the present study was that hydration with sodium bicarbonate was more effective than with sodium chloride for the prevention of contrast-induced nephropathy in patients with renal dysfunction undergoing an emergency coronary procedure. The incidence of contrast-induced nephropathy in the sodium chloride group (35%) was similar to that in previous studies dealing with patients with acute myocardial infarction undergoing primary angioplasty.11, 12 The risk ratio of
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