Effect of trimetazidine on preventing contrast-induced nephropathy in diabetic patients with renal insufficiency

BACKGROUND: Our study sought to assess the effect of trimetazidine (TMZ) on preventing contrast-induced nephropathy (CIN) in diabetic patients with renal insufficiency. MATERIALS AND METHODS: 106 diabetic patients with renal insufficiency who were undergoing coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) were enrolled in this study. Standard hydration was administered to both groups (the TMZ group and the control group). In the TMZ group, patients were orally administered TMZ for 48 hours before and 24 hours after CAG and/or PCI. Serum creatinine (Scr), cystatin C and the glomerular filtration rate (eGFR) were measured before as well as 24 hours, 48 hours and 72 hours after contrast media injection. The incidence of CIN and major cardiovascular events (MACE) was also evaluated in both groups. RESULTS: Scr, cystatin C and the eGRF in the TMZ group were better than those in the control group after 24 hours (OR: 0.78, 95% CI: 0.54–0.82; OR: 0.66, 95% CI: 0.62–0.73; OR: 1.2, 95% CI: 1.02–1.53, respectively), 48 hours (OR: 0.69, 95% CI: 0.52–0.73; OR: 0.76, 95% CI: 0.69–0.84; OR: 1.5, 95% CI: 1.25–1.68, respectively) and 72 hours (OR: 0.82, 95% CI: 0.77–0.91; OR: 0.85, 95% CI: 0.71–0.92; OR: 1.67, 95% CI: 1.33–1.72, respectively). The incidence of CIN (9.26% vs 16.67%) and MACE (7.41% vs 18.51%) in the TMZ group was significantly lower than that in the control group (P < 0.05). CONCLUSIONS: Our study suggests that TMZ could reduce the incidence of CIN and MACE in diabetic patients with renal insufficiency who are undergoing CAG and/or PCI.