The Effects Of Angiotensin Enzyme Inhibitors And Angiotensin Receptor Blockers Therapy On Contrast-Induced Nephropathy In Patients Undergoing PCI Or CAG

Objective:To evaluate the effect of angiotensin enzyme inhibitors(ACEI) and angiotensin receptor blockers(ARB) therapy on contrast-induced nephropathy(CIN) in patients undergoing coronary angiogram (CAG) or percutaneous coronary intervention (PCI).Methods:A search was conducted in PubMed, The Cochrane library, VIP, CNKI and Wanfang Data for literatures about ACEI or ARB and CIN up to august 2014. According to the inclusion and exclusion criteria, articles were screened and data were extracted and quality of included studies was evaluated. Mata -analysis was conducted by using Stata 11.0 software. Moreover, Begg’s and Egger’s regression were used to assess the publication bias of included articles.Result:Eleven studies were included. Among the patients undergoing PCI or coronary angiogram (CAG), compared to control group, usage of ACEI/ARB before those operations does not increasing the risk of CIN, and there is no significant difference was found (RR=0.78; 95% CI:0.53 to 1.15; P=0.22). In subgroup analysis, subgroups with duration of ACEI/ARB treatment at least 2 weeks (RR= 0.78,95%CI:0.37 to 1.62, P=0.50) and less than 2 weeks (RR=0.79,95%CI:0.50 to 1.24, P=0.30)both had no influence on the incidence of CIN. While the risk of CIN at the moment of 72 hours after coronary intervention therapy was decreased (RR=0.23; 95%CI:0.23 to 0.87; P=0.02) and the subgroup of less amount of contrast agent(< 150ml) shows a decreasing incidence of CIN(RR=0.57; 95%CI:0.33 to 0.99;P=0.046).Conclusion:There has been no evidence to suggest that use of ACEI/ARB will increase the risk of CIN in patients undergoing PCI/CAG, at present.