Effects Of Vitamins For The Prevention Of CIN After Coronary Angiography:A Meta-analysis

Objective:To evaluate the effects of vitamins for the prevention of contrast induced nephropathy(CIN)after coronary angiography through the Meta-analysis.Method:We search PubMed,EmBase,Cochrane Library Central Register of Controlled Trials,and ClinicalTrails.gov for related literatures,we choosed the RCTs and extract the data accorded with selection criteria using a suitable form.All the statistical analyses were performed with RevMan 5.3.Results:1.A total of 11 eligible RCTs and 1 810 patients were included,951 patients were in vitamins groups and 859 were in placebo groups,the average age of 11 RCTs was 60–73,The proportion of men was 45.9%–92.2%.2.Meta-analysis showed the incidence of CIN in vitamins groups was obviously lower than the placebo groups(RR=0.54,95% CI 0.39– 0.73).It can be seen from the funnel plot that the distribution of each point is symmetrical,and most of the studies are evenly distributed.It is considered that the publication bias of this meta-analysis is low.The sensitivity analysis of the high quality RCTs(Jadad scores were 4-7)was good(RR=0.53,95%CI:0.35–0.78,P=0.002).3.Subgroup analysis showed 6 ascorbic acid subgroups reduced CIN incidence by 42%(RR=0.58,95%CI=0.37-0.90).3 vitamin E groups reduced the incidence of CIN by 52%(RR=0.48,95%CI:0.30–0.77).The subgroups of abnormal renal function had a 47% lower incidence of CIN(RR=0.53,95%CI=0.38–0.73).The subgroups of oral administration reduced the incidence of CIN by 51%(RR=0.49,95%CI=0.35–0.69).The subgroups of low proportion of diabetic patients reduced the incidence of CIN by 54%(RR=0.46,95%CI=0.31–0.68).The results of the other subgroups were not statistically significant.Conclusion:Compared with the placebo groups,the use of vitamins can reduce the incidence of CIN after coronary angiography significantly.The results of this Meta-analysis need to be verified by more high-quality,large-sample and multi-center RCT studies.