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This study sought to investigate the preventive effect of coenzyme Q10 (CoQ10) combined with trimetazidine(TMZ) on contrast-induced nephropathy(CIN) in patients with renal insufficiency undergoing elective cardiac catheterization.
A total of 160 consecutive patients with renal insufficiency undergoing elective cardiac catheterization were randomly assigned to CoQ10 plus TMZ group(n=80) and control group(n=80). In CoQ10 plus TMZ group, both of CoQ10 and TMZ were administered 20mg three times daily from 2 days before to 3 days after procedure. Control group were matching placebo as the same method. All patients had basic cardiovascular drug treatment. The primary endpoint was the incidence of CIN defined as 25 % increase in serum creatinine (SCr) from baseline or 44 μmol/L (0.5 mg/dL) increase in absolute value within 72 h after exposure to contrast medium. The secondary endpoints were: (1)the levels of SCr, Cystatin-C (Cys-C) and eGFR within 72 h; (2) major adverse cardiovascular events (MACE) occurring within 30 days.
Baseline characteristics of the patients in the two groups were similar. Compared with the control group, CoQ10 plus TMZ group tended to have a lower SCr and Cys-C 48h after the procedure (all P<0.05). The incidence of CIN was significantly lower in CoQ10 plus TMZ group compared with control group (6.25 vs. 18.75 %, P=0.017). There was no difference about the incidence of adverse events within 30 days between CoQ10 plus TMZ group and control group (3.75 vs. 7.50%, P=0.49).
In conclusion, we demonstrated that oral CoQ10 combined with TMZ could decrease the incidence of CIN in patients with renal insufficiency undergoing elective cardiac catheterization. The combination therapeutic efficacy of CoQ10 and TMZ observed in this study suggests the potential of this drug as an additional option in prevention of CIN.