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Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial

Background: Contrast-associated acute kidney injury (CA-AKI) is still a major concern for referring physicians, especially in the setting of ST-elevation myocardial infarction (STEMI) patients undergoing primary-PCI (pPCI). To evaluate whether glutathione sodium salt (GSS) infusion impacts favorably...

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Autores principales: Arrivi, Alessio, Pucci, Giacomo, Sordi, Martina, Dominici, Marcello, Barillà, Francesco, Carnevale, Roberto, Morgantini, Amalia, Rosati, Riccardo, Mangieri, Enrico, Tanzilli, Gaetano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304815/
https://www.ncbi.nlm.nih.gov/pubmed/37374173
http://dx.doi.org/10.3390/life13061391
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author Arrivi, Alessio
Pucci, Giacomo
Sordi, Martina
Dominici, Marcello
Barillà, Francesco
Carnevale, Roberto
Morgantini, Amalia
Rosati, Riccardo
Mangieri, Enrico
Tanzilli, Gaetano
author_facet Arrivi, Alessio
Pucci, Giacomo
Sordi, Martina
Dominici, Marcello
Barillà, Francesco
Carnevale, Roberto
Morgantini, Amalia
Rosati, Riccardo
Mangieri, Enrico
Tanzilli, Gaetano
author_sort Arrivi, Alessio
collection PubMed
description Background: Contrast-associated acute kidney injury (CA-AKI) is still a major concern for referring physicians, especially in the setting of ST-elevation myocardial infarction (STEMI) patients undergoing primary-PCI (pPCI). To evaluate whether glutathione sodium salt (GSS) infusion impacts favorably on CA-AKI, an unplanned exploratory data analysis of the GSH 2014 trial was performed. Methods: One hundred patients with STEMI were assigned at random to an experimental group (No. 50) or to a placebo group (No. 50). Treatment consisted of an intravenous infusion of GSS lasting over 10 min before p-PCI. The placebo group received the same quantity of normal saline solution. After the interventions, glutathione was administered in the same doses to both groups at 24, 48 and 72 h. Results: CA-AKI occurred in 5 out of 50 patients (10%) allocated to the experimental group (GSS infusion) and in 19 out of 50 patients (38%) allocated to the placebo group (p between groups < 0.001). No patients in either group required renal replacement therapy. After allowing for multiple confounders, GSS administration (OR 0.17, 95% CI 0.04–0.61) and door-to-balloon time (in hours) (OR 1.61, 95% CI 1.01–2.58) have been the only independent predictors of CA-AKI. Conclusions: the results of this sub-study, which show a significant trend towards an improved nephroprotection in the experimental group, led to the hypothesis of a possible new prophylactic approach to counteract CA-AKI using repeated GSS infusion. Subsequent studies with specific clinical outcomes would be necessary to confirm these data.
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spelling pubmed-103048152023-06-29 Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial Arrivi, Alessio Pucci, Giacomo Sordi, Martina Dominici, Marcello Barillà, Francesco Carnevale, Roberto Morgantini, Amalia Rosati, Riccardo Mangieri, Enrico Tanzilli, Gaetano Life (Basel) Brief Report Background: Contrast-associated acute kidney injury (CA-AKI) is still a major concern for referring physicians, especially in the setting of ST-elevation myocardial infarction (STEMI) patients undergoing primary-PCI (pPCI). To evaluate whether glutathione sodium salt (GSS) infusion impacts favorably on CA-AKI, an unplanned exploratory data analysis of the GSH 2014 trial was performed. Methods: One hundred patients with STEMI were assigned at random to an experimental group (No. 50) or to a placebo group (No. 50). Treatment consisted of an intravenous infusion of GSS lasting over 10 min before p-PCI. The placebo group received the same quantity of normal saline solution. After the interventions, glutathione was administered in the same doses to both groups at 24, 48 and 72 h. Results: CA-AKI occurred in 5 out of 50 patients (10%) allocated to the experimental group (GSS infusion) and in 19 out of 50 patients (38%) allocated to the placebo group (p between groups < 0.001). No patients in either group required renal replacement therapy. After allowing for multiple confounders, GSS administration (OR 0.17, 95% CI 0.04–0.61) and door-to-balloon time (in hours) (OR 1.61, 95% CI 1.01–2.58) have been the only independent predictors of CA-AKI. Conclusions: the results of this sub-study, which show a significant trend towards an improved nephroprotection in the experimental group, led to the hypothesis of a possible new prophylactic approach to counteract CA-AKI using repeated GSS infusion. Subsequent studies with specific clinical outcomes would be necessary to confirm these data. MDPI 2023-06-14 /pmc/articles/PMC10304815/ /pubmed/37374173 http://dx.doi.org/10.3390/life13061391 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Arrivi, Alessio
Pucci, Giacomo
Sordi, Martina
Dominici, Marcello
Barillà, Francesco
Carnevale, Roberto
Morgantini, Amalia
Rosati, Riccardo
Mangieri, Enrico
Tanzilli, Gaetano
Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial
title Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial
title_full Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial
title_fullStr Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial
title_full_unstemmed Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial
title_short Repeated Glutathione Sodium Salt Infusion May Counteract Contrast-Associated Acute Kidney Injury Occurrence in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Randomized Subgroup Analysis of the GSH 2014 Trial
title_sort repeated glutathione sodium salt infusion may counteract contrast-associated acute kidney injury occurrence in st-elevation myocardial infarction patients undergoing primary pci: a randomized subgroup analysis of the gsh 2014 trial
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304815/
https://www.ncbi.nlm.nih.gov/pubmed/37374173
http://dx.doi.org/10.3390/life13061391
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