SynthesisClinical cardiology2004
Role of N-acetylcysteine in prevention of contrast-induced nephropathy after cardiovascular procedures: a meta-analysis.
Synthesis in Clinical cardiology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 5 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Cardiological Society of India practice guidelines for angiography in patients with renal dysfunction.Indian heart journal · 2012Guideline
- Sodium bicarbonate plus N-acetylcysteine prophylaxis: a meta-analysis.JACC. Cardiovascular interventions · 2009Pooled it
- Acute renal failure.BMJ clinical evidence · 2008Pooled it
- A meta-analysis of N-acetylcysteine in contrast-induced nephrotoxicity: unsupervised clustering to resolve heterogeneity.BMC medicine · 2007Pooled it
- Compliance with QUOROM and quality of reporting of overlapping meta-analyses on the role of acetylcysteine in the prevention of contrast associated nephropathy: case study.BMJ (Clinical research ed.) · 2006Pooled it
- Optimizing the Outcomes of Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease.Journal of clinical medicine · 2022Review
- The Multifaceted Therapeutic Role of N-Acetylcysteine (NAC) in Disorders Characterized by Oxidative Stress.Current neuropharmacology · 2021Review
- Pharmacological strategies to prevent contrast-induced acute kidney injury.BioMed research international · 2014Review
- Prevention of contrast-induced AKI: a review of published trials and the design of the prevention of serious adverse events following angiography (PRESERVE) trial.Clinical journal of the American Society of Nephrology : CJASN · 2013Review
- Radiographic contrast-media-induced acute kidney injury: pathophysiology and prophylactic strategies.ISRN radiology · 2013Review
- Preventing radiocontrast-induced nephropathy in chronic kidney disease patients undergoing coronary angiography.World journal of cardiology · 2012Article
- Contrast-induced acute kidney injury: short- and long-term implications.Seminars in nephrology · 2011Review
- Glomerular filtration rate and coronary artery disease burden in patients with acute coronary syndrome.Clinical cardiology · 2007Article
- N-acetylcysteine -- passe-partout or much ado about nothing?British journal of clinical pharmacology · 2006Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundContrast-induced nephropathy is one of the common causes of acute renal insufficiency after cardiovascular procedures. HYPOTHESIS: The objective of this paper was to analyze the published data on the usefulness of N-acetylcysteine in the prevention of contrast-induced nephropathy after these procedures.
methodsTrials were selected if they were prospective, randomized, controlled, had selected patients with impaired renal function, used low-osmolality, nonionic contrast media intra-arterially, administered a total of four doses of N-acetylcysteine in addition to intravenous saline hydration, and had contrast-induced nephropathy as their primary outcome. Contrast-induced nephropathy was defined as an increase in serum creatinine concentration by >0.5 mg/dl or a 25% increase above baseline at or within 48 h post procedure. Meta-analysis was performed using the Fisher's Combined Test with a measure of effect size. The magnitude of the N-acetylcysteine effect was estimated using random-effects models. Homogeneity was evaluated using the chi-square test of homogeneity and standard Q statistic. Reporting bias was explored by the Rosenthal method.
resultsThe Fisher's Combined Test was significant at p < 0.005 in favor of N-acetylcysteine. The size of the N-acetylcysteine effect was to reduce contrast-induced nephropathy by 20%. There was a 62% relative risk reduction in contrast-induced nephropathy with N-acetylcysteine using a fixed-effects model, and a 70% relative risk reduction using the random-effects model. In addition, we found that 27 unpublished trials showing no effects of N-acetylcysteine would exist to overturn the combined significance of p < 0.005 of the five trials in our meta-analysis.
conclusionOral administration of N-acetylcysteine in addition to intravenous saline hydration has a beneficial effect in the prevention of contrast-induced nephropathy after cardiovascular procedures in patients with impaired renal function.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.