SynthesisFrontiers in cardiovascular medicine2026
Remote ischemic preconditioning reduces contrast-induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention: an updated meta-analysis of randomized controlled trials.
Synthesis in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
Background: Contrast-induced nephropathy (CIN) is a common complication following coronary angiography (CA) or percutaneous coronary intervention (PCI) and is associated with prolonged hospitalization and adverse clinical outcomes. Remote ischemic preconditioning (RIPC), a noninvasive and nonpharmacological intervention, has been proposed as a potential strategy for preventing CIN. However, evidence from randomized controlled trials (RCTs) remains inconsistent. Methods: This meta-analysis of RCTs aimed to evaluate the efficacy of RIPC for preventing CIN in patients undergoing CA or PCI. The primary outcome was the incidence of CIN. For dichotomous outcomes, risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using the Mantel-Haenszel fixed-effect model. For continuous outcomes, standardized mean differences (SMDs) with 95% CIs were pooled using a fixed-effect model when heterogeneity was low and a random-effects model when substantial heterogeneity was present. Trial sequential analysis was performed for dichotomous outcomes to estimate the robustness of the cumulative evidence and the required information size. This study was prospectively registered with PROSPERO (CRD420251269657). Results: Twenty-six RCTs including 4,169 participants were included. Overall, RIPC significantly reduced the risk of CIN compared with the control treatment (RR 0.49, 95% CI 0.41-0.59, Conclusion: In patients undergoing coronary angiography or percutaneous coronary intervention, RIPC was associated with reduced risks of CIN and MAEs, attenuated postprocedural increases in serum creatinine levels, and lower postprocedural serum creatinine levels, while evidence for postprocedural eGFR, NGAL, cystatin C, and clinical outcomes remains inconclusive. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251269657, PROSPERO CRD420251269657.
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