Pentoxifylline and prevention of contrast-induced nephropathy: Is it efficient in patients with myocardial infarction undergoing coronary angioplasty?

BACKGROUND: Contrast-induced nephropathy (CIN) is a major concern following procedures with applying iodinated contrast media. The basis prevention of CIN is hydration and to avoid hypovolemia. We aimed to evaluate the efficacy of pentoxifylline (PTX) for the prevention of CIN in patients with myocardial infarction (MI) undergoing coronary angioplasty. METHODS: This prospective, single-blind, randomized clinical trial study was performed on ۱۷۵ (۱۲۷ men) of MI patients undergoing routine treatment. Patients were assigned randomly to the control (n = ۸۴) and study groups (n = ۹۱). In our study group, patients received ۴۰۰ mg/۳ times a day from ۲۴ hours before to ۲۴ hours after coronary angiography. In addition, before the procedure and after ۴۸ hours from the procedure, serum creatinine was measured. RESULTS: CIN occurred in ۱۴ patients (۸.۰%); ۸ controls (۹.۵%) and ۶ patients (۶.۶%) in the PTX group )P = ۰.۴۷۵) showing PTX to have no significant effect on CIN [P = ۰.۷۵۰, odds ratio = ۰.۸۲ (confidence interval = ۰.۲۴-۲.۸)] though a significantly different volume of contrast was used between the groups (۲۳۱.۲۹ ± ۱۰۵.۱۰ mm۳ and ۱۹۰.۸۸ ± ۷۵.۸۲ mm۳; P = ۰.۰۰۵, respectively). CONCLUSION: There was no significantly different occurrence of CIN on patients with MI, undergoing coronary angioplasty, but its relatively lower rate in PTX group would recommend the prophylactic oral use of PTX for CIN prevention. 

Keywords:

Pentoxifylline , Myocardial Infarction , Contrast Media , Angioplasty , Nephropathy , Creatinine