Impact of Trimetazidine on Incidence of Contrast Induced Nephropathy in Diabetic Patients with Renal Insufficiency Undergoing Percutaneous Coronary Intervention

Abstract

Najah R. Hadi, Khalid I. Amber, Hussein A. Alsalkhi, Bashaer M. Muhammad-Baqir, Mustafa H. Ahmed.

The main objective of this study is to assess the possible protective role of Trimetazidine in the prevention of contrast induced nephropathy in patients with renal impairment undergoing coronary angiography or percutaneous coronary intervention. This was a randomized single-blind clinical trial study. A total of 100 consecutive diabetic patients with symptomatic ischemic heart disease and chronic kidney disease (CKD) were subjected to an elective percutaneous coronary intervention, at ALSADR teaching hospital /Al-Najaf Center for Cardiac surgery and Tran Catheter Therapy, Najaf, Iraq, in period between May and December 2018. The Patients were divided into two groups: Group I-Control Group (n=45) these patients with chronic kidney disease and critical coronary stenosis and they were needed to be subjected to coronary intervention. Group II- Treatment Group (n=44) also these patients with chronic kidney disease and critical coronary stenosis and they were need to be subjected to coronary intervention and treated with 35 mg tablet /twice daily of Trimetazidine for the period of three days , starting 48 hours before surgical procedure and for 24 hours post the procedure.
Trimetazidine significantly reduce the elevation in serum levels of nuclear factor kappa B , high-mobility group box 1, expression of Toll-like receptor 2 (p<0.05) while insignificantly reduce the elevation in serum levels of creatinine and urine level of Neutrophils gelatinase-associated lipocalinis (p > 0.05). Our study concluded that Trimetazidine reduce the acute kidney injury response and systemic inflammatory response induced by contrast administration after coronary intervention.