Selenium for the Prevention of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography and Percutaneous Interventions: A Double-Blinded Randomized Controlled Trial
|Hamid Reza Sanati1, Behdad Bahadorian2*, Ali Zahedmehr1, Farshad Shakerian1, Ata Firouzi1, Reza Kiani1, Sakineh Pedarpour2, Hossein Fathi2, Ali Reza Tatina2 and Nasrin Azizian2|
|1Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran|
|2Depatment of Cardiology, Rajaie Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran|
|Corresponding Author :||Behdad Bahadorian
Cardiovascular Intervention Research Centre
Rajaie Cardiovascular, Medical & Research Center
Tehran University of Medical Science, Tehran, 1413814587, Iran
Tel: +98 21 23922178
Mobile: +98 9121874093
Fax: +98 2122055594
|Received July 23, 2014; Accepted September 03, 2014; Published September 13, 2014|
|Citation: Sanati HR, Bahadorian B, Zahedmehr A, Shakerian F, Firouz A, et al. (2014) Selenium for the Prevention of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography and Percutaneous Interventions: A Double-Blinded Randomized Controlled Trial. J Clin Exp Cardiolog 5:335. doi:10.4172/2155-9880.1000335|
|Copyright: © 2014 Bahadorian B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Background: Contrast-induced nephropathy (CIN) is a common cause of acute kidney injury and is associated with significant morbidity and mortality even if transient or successfully treated. The preventive measures currently available have failed to show significant efficacy. Selenium, which is involved in anti-oxidative reactions, might have protective effects against CIN.
Methods: 237 patients undergoing coronary angiography or intervention were randomly assigned to receive placebo (n=120) or selenium (200 mcg daily on the pre-procedural day, procedural day, and the first post-procedural day) (n=117). Serum creatinine was measured before and two days after the procedure. The primary endpoint was the occurrence of CIN within forty-eight hours.
Results: Baseline characteristics were not different between the groups. CIN occurred in 13 (11.1%) patients in the selenium group and in 23 (19.2%) in the placebo group (odds ratio (or) 95% confidence interval (CI): 1.72 (0.92-3.24), p value=0.084). Selenium intake was significantly associated with lower rates of CIN in the males (or (95% CI): 2.33 (1.10-5.48), p value=0.04), hypertensive patients (or (95% CI): 2.69 (1.12-7.53), p value=0.04), those with a left ventricular ejection fraction <50% (or (95% CI): 5.38 (1.26-22.9), p value=0.008), and those who underwent percutaneous coronary interventions (or (95% CI): 1.98 (1.01-3.99), p value=0.04).
Conclusion: Selenium, as an antioxidant, might decrease the occurrence of CIN, especially in high-risk patients undergoing coronary angiography or percutaneous coronary intervention. Nevertheless, routine recommendation of selenium to these patients needs further investigations.