Evidence map›Paper›PMID 39937383›Full record

SynthesisInternational urology and nephrology2025

Efficacy and safety of nicorandil for prevention of contrast-induced nephropathy in patients undergoing coronary procedures: a systematic review and meta-analysis.

Ayesha Imran Butt, Fazila Afzal, Sukaina Raza, F N U Namal, Dawood Ahmed, Hassaan Abid, Muhammad Hudaib, Zainab Safdar Ali Sarwar, Soha Bashir, Asadullah Khalid and 9 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International urology and nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Ayesha Imran ButtDepartment of Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
Fazila AfzalDepartment of Medicine, Faisalabad Medical University, Faisalabad, Pakistan.
Sukaina RazaDepartment of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan.
F N U NamalDepartment of Medicine, Shifa International Hospital, Faisalabad, Pakistan.
Dawood AhmedDepartment of Medicine, Faisalabad Medical University, Faisalabad, Pakistan.
Hassaan AbidDepartment of Medicine, IU Ball Memorial Hospital, Muncie, IN, USA.
Muhammad HudaibDepartment of Medicine, Fazaia Ruth Pfau Medical College, Karachi, Pakistan.
Zainab Safdar Ali SarwarDepartment of Medicine, Sahiwal Medical College, Sahiwal, Pakistan.
Soha BashirDepartment of Medicine, Jinnah Hospital, Lahore, Pakistan.
Asadullah KhalidDepartment of Medicine, Aziz Fatimah Medical & Dental College, Faisalabad, Pakistan.
Umer HassanDepartment of Nephrology, Shaikh Zayed Hospital, Lahore, Pakistan.
Mohammad Ebad Ur RehmanDepartment of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan. ebadrehman.rehman@gmail.com.
Huzaifa Ahmad CheemaDepartment of Cardiology, King Edward Medical University, Lahore, Pakistan. huzaifaahmadcheema@gmail.com.
Ali HusnainDepartment of Radiology, Northwestern University, Chicago, IL, USA.
Usama AnwarDepartment of Interventional Radiology, Boston Children's Hospital, Boston, MA, USA.
Muhammad Mohid TahirDepartment of Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, New York, NY, USA.
Adeel AhmadDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Wajeeh Ur RehmanDepartment of Internal Medicine, United Health Services Hospital, Johnson City, NY, USA.
Raheel AhmedNational Heart & Lung Institute, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundContrast-induced nephropathy (CIN) is a potentially serious complication of intravenous or intra-arterial contrast administration during angiographic procedures that results in renal dysfunction. CIN can increase the risk of mortality by three-fold. This meta-analysis assesses the efficacy and safety of nicorandil for the prevention of CIN in patients undergoing percutaneous coronary intervention (PCI) or coronary angiography (CAG).

methodsCochrane Central Register of Controlled Trials, MEDLINE, Embase, and ClinicalTrials.gov were used to perform a thorough literature search from their inception to July 2024. Twelve randomized controlled trials (RCTs) were included. A random-effects meta-analysis was performed on RevMan and pooled estimates were presented as forest plots. The Mantel-Haenszel method was used for dichotomous outcomes and risk ratios (RRs) were calculated along with 95% confidence intervals (95% CI).

resultsThis meta-analysis included 2787 participants (nicorandil: 1418, control: 1394). The use of nicorandil was protective against CIN (RR 0.38, 95% CI 0.29-0.50). There was no significant difference in major adverse events between the groups (RR 0.77, 95% CI 0.52-1.13, p = 0.18). Similarly, the use of nicorandil did not affect the risk of developing stroke (RR 1.05, 95% CI: 0.38-2.95), myocardial infarction (RR 0.90, 95% CI: 0.56-1.43), heart failure (RR 0.81, 95% CI: 0.39-1.68), cardiac death (RR 0.90, 95% CI: 0.28-2.88) and dialysis (RR 0.70, 95% CI: 0.11-4.44).

conclusionThis meta-analysis concludes that nicorandil reduces CIN incidence after PCI or CAG without significantly increasing major adverse events. However, further well-designed, large-scale RCTs are needed to strengthen the practical relevance before routine clinical use.

Indexed as

Contrast MediaCoronary AngiographyKidney DiseasesNicorandilPercutaneous Coronary InterventionHumansContrast MediaNicorandilContrast-inducted nephropathyCoronary interventionNicorandilPCI

Identifiers

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.