Inorganic Nitrate Treatment Cuts Rate of Contrast-Induced Nephropathy

THURSDAY, March 28, 2024 (HealthDay News) -- For patients presenting with acute coronary syndromes (ACS) undergoing coronary angiography, inorganic nitrate treatment reduces the rate of contrast-induced nephropathy (CIN), according to a study published online March 21 in the European Heart Journal.

Daniel A. Jones, M.D., Ph.D., from the Queen Mary University of London, and colleagues conducted a double-blind, randomized trial to assess the efficacy of inorganic nitrate in CIN prevention in at-risk patients presenting with ACS. Patients were randomly assigned to receive once-daily potassium nitrate (12 mmol) or placebo (319 and 321, respectively) for five days.

The researchers found that the rates of CIN were significantly reduced with inorganic nitrate treatment versus placebo (9.1 versus 30.5 percent, respectively). After adjustment for baseline creatinine and diabetes status, the difference persisted (odds ratio, 0.21). Improvements were seen in secondary outcomes with inorganic nitrate versus placebo, with significantly lower rates of procedural myocardial infarction (2.7 versus 12.5 percent), improved three-month renal function (between-group change in estimated glomerular filtration rate, 5.17), and significantly reduced one-year major adverse cardiac events (MACE; 9.1 versus 18.1 percent).

"In patients at risk of kidney injury undergoing coronary angiography for ACS, dietary inorganic nitrate reduces CIN compared to placebo," the authors write. "This corresponded to improved kidney outcomes at three months and MACE events at 12 months, findings which could have important implications for reducing the burden on the National Health Service."

One author disclosed being a director of HeartBeet Ltd.

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