Effects of intravenous hydration on risk of contrast induced nephropathy and in-hospital mortality in STEMI patients undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials

Liu, Yong, Hong, Daqing, Wang, Amanda Ying, Guo, Rui, Smyth, Brendan, Liu, Jin, Sun, Guoli, Chen, Shiqun, Tan, Ning, Jardine, Meg, Brieger, David, Shaman, Ahmed, Islam, Shariful, Chen, Jiyan and Gallagher, Martin 2019, Effects of intravenous hydration on risk of contrast induced nephropathy and in-hospital mortality in STEMI patients undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials, BMC cardiovascular disorders, vol. 19, pp. 1-9, doi: 10.1186/s12872-019-1054-y.

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Title Effects of intravenous hydration on risk of contrast induced nephropathy and in-hospital mortality in STEMI patients undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials
Author(s) Liu, Yong
Hong, Daqing
Wang, Amanda Ying
Guo, Rui
Smyth, Brendan
Liu, Jin
Sun, Guoli
Chen, Shiqun
Tan, Ning
Jardine, Meg
Brieger, David
Shaman, Ahmed
Islam, SharifulORCID iD for Islam, Shariful orcid.org/0000-0001-7926-9368
Chen, Jiyan
Gallagher, Martin
Journal name BMC cardiovascular disorders
Volume number 19
Article ID 87
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2019-12
ISSN 1471-2261
Keyword(s) Intravenous hydration
Contrast-induced nephropathy
ST-segment elevation-myocardial infarction
Primary percutaneous coronary intervention
acute kidney injury
dialysis
mortality
Summary BackgroundThe role of intravenous hydration at the time of primary percutaneous intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains unclear. Guidelines are vague, supported by low level evidence, and hydration is used less often than other clinical settings.To perform a systematic review and meta-analysis of all randomized controlled trials assessing intravenous hydration compared with non-hydration for prevention of contrast induced nephropathy (CIN) and In-hospital mortality in patients with STEMI undergoing primary PCI.MethodsMedline, EMBASE and the Cochrane Register were searched to September 2018. Included studies reported the incidence of CIN, In-hospital mortality, requirement for dialysis and heart failure. Relative risks with 95% confidence intervals (CIs) for individual trials were pooled using a random effects model.ResultsThree moderate quality trials were identified including 1074 patients. Overall, compared with no hydration, intravenous hydration significantly reduced the incidence of CIN by 42% (RR 0.58; 95% CI: 0.45 to 0.74, p < 0.001). The estimated effects upon all-cause mortality (RR 0.56; 95% CI: 0.30 to 1.02, p = 0.057) and the requirement for dialysis (RR 0.52, 95% CI 0.14–1.88, p = 0.462) were not statistically significant. The outcome of heart failure was not consistently reported.ConclusionsIntravenous hydration likely reduces the incidence of CIN in patients with STEMI undergoing primary PCI. However, for key clinical outcomes such as mortality, heart failure and dialysis the effect estimates were imprecise. Further high quality studies are needed to clarify the appropriate volume of fluid and effects on outcomes.
Language eng
DOI 10.1186/s12872-019-1054-y
Field of Research 1102 Cardiorespiratory Medicine and Haematology
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, The Author(s)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30120872

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