Treatment of contrast-induced nephropathy with pitavastatin combined with N-acetylcysteine in patients undergone percutaneous coronary intervention

Fan Xuexiu; Zu Yugang

doi:10.3969/j.issn.1674-4055.2019.11.17

Abstract：investigate the preventive effect of pitavastatin combined with N-acetylcysteine (NAC) in routine dose on contrast-induced nephropathy (CIN) in patients after percutaneous coronary intervention (PCI), and discuss possible effective mechanism. Methods The patients with coronary heart disease (CHD) undergone PCI (n=126) were chosen from Department of Cardiology in the First Hospital of Baoding City from Oct. 2017 to Oct. 2018. All patients were divided, according to random digital table, into control group (group A, n=42), routine-dose pitavastatin group (group B, n=42) and routine-dose pitavastatin combined with NAC group (group C, n=42). The levels of serum creatinine (SCr), malondialdehyde (MDA) and superoxide dismutase (SOD) were detected after collecting samples of peripheral venous blood from the patients before and after PCI for 24 h and 72 h. The endogenous creatinine clearance rate (CCr) was calculated by using Cockcroft-Gault formula. Results The comparison in general clinical materials and biochemical indexes showed the differences had no statistical significance among 3 groups before PCI (all P>0.05). Compared with before, the levels of Scr and MDA increased (all P<0.05) and level of CCr decreased (P<0.05) in group A after PCI for 24 h. The levels of Scr and MDA increased (all P<0.05) and levels of CCr and SOD decreased (all P<0.05) in groups A and B after PCI for 72 h. Compared with before, the changes of levels of Scr, CCr, MDA and SOD had no statistical significance in group C after PCI for 24 h and 72 h (all P>0.05). There were 7 cases (16.7%) of CIN in group A, 3 (7.1%) in group B and 0 (0%) in group C, and CIN incidence rate was lower in group C than that in group A (P<0.05). Conclusion Pitavastatin combined with NAC taken before PCI can protect kidney function to some extent in CHD patients, and antioxidation stress may be the mechanism of protecting kidney function.