A five -day treatment with inorganic nitrate once a day reduce The risk of a serious complication after coronary angiography, in which the dye used causes damage to the kidneys, according to a clinical trial, directed by the Queen Mary of London University (United Kingdom). The work, published in ‘European Heart Journal‘He also showed that five -day treatment improves the renal results at three months and the major adverse heart events (MACE) per year compared to the placebo.
In depth
Contrast -induced nephropathy (Nic), also known as acute renal injury associated with contrast (CA-AKI), is a rare but serious complication after coronary angiography. Coronary angiography is a common use procedure that It allows health professionals to examine the blood supply to the heart. A special dye is injected into the bodywhich is visible in radiographs, and when the dye reaches the coronary arteries, an radiography is taken.
While coronary angiography is safe for most people, some patients have a high risk of nic, which is an important cause of death and critical disease in high -risk patients who have undergone coronary angiographic procedures.
For older people and those with heart failure, chronic kidney disease (ERC) or diabetes with ERC, the incidence of NIC can reach 55%. NIC may have serious consequences for patients, including longer hospital stays, a greater need for kidney transplants, recurrent revascularization procedures and greater mortality.
More details
It is believed that one of the main mechanisms underlying NIC is an increase in oxidative stress and the consequent decrease in nitric oxide protective levels (NO) in the body. This random controlled essay, led by Professor Amrita Ahluwalia from the Queen Mary of London’s university examined whether the ingestion of inorganic nitrate (NO3-), which becomes nitrite (No2-) and then not in the body, could Compensate the loss of no in the body and helps prevent renal lesion in high -risk patients who receive contrast angiography.
In the essay they participated 640 patients undergoing angiography by acute coronary syndrome (SCA) Without ST (SCASEST) elevation in Barts Health NHS Trust, 319 received inorganic nitrate capsules (potassium nitrate) once a day and 321 received a placebo capsule. (potassium chloride).
The study showed that patients who received treatment with inorganic nitrate had significantly reduced NIC rates (9.1%) compared to placebo (30.5%), lower rates of myocardial infarction by procedure (2.7%compared to 12.5%), a better renal function at three months and a reduction in renal function at one year a year of major adverse cardiac events (MACE) (9.1% compared to 18.1%) compared to patients who had received placebo treatment.
These findings together support the concept of replacement of not in the form of a short single -day inorganic nitrate capsule of five days as a potential solution to prevent NIC and improve cardiovascular and renal results after a SCA.
To take into account
The teacher Amrita AhluwaliaDean of Research of the Faculty of Medicine and Dentistry of Queen Mary, says: “The current reference treatment for the blocked coronary arteries is the insertion of a stent. For this the cardiologist needs to be able to see where The artery is blocked and that is why it is necessary to use a dye to allow the artery to be seen clearly in angiography“
“This trial suggests that a simple five -day regime of low -cost inorganic nitrate capsules eliminates the risk of what so far were inevitable harmful effects. We hope to confirm these findings in a great multicenter essay in the near future, but the nitrate-cin results give us hope“He concludes.
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