Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional

Background: Contrast-induced nephropathy (CIN) is one of the most common complications after coronary stent implantation due to the extensive development of coronary catheterization technology. Compound Danshen dripping pills (CDDP) are clinically used as cardiovascular drugs, relieving systemic inflammatory response. Previous studies have observed that CDDP can decrease CIN incidence after coronary stent implantation with uncertain effectiveness.Methods: We conducted a prospective, randomized, single-center, single-blind, controlled trial. We enrolled patients 18 years and older with unstable angina pectoris and NSTEMI who underwent PCI at the Tianjin Chest Hospital between November 1, 2021, and November 31, 2022, and followed for 30 days. Patients were randomized to CDDP and hydration therapy (10 capsules three times/day; N = 411) or hydration only (N = 411). The primary outcome was the contrast nephropathy incidence, defined as an elevation in serum creatinine by more than 25% or 44 mu mol/L from baseline within 48-72 h of contrast exposure. Secondary outcomes included major adverse cardiovascular events post-surgery and during follow-up.Results: After 48 h of operation, the two groups had statistical significance in Scr and BUN values (80.0 +/- 12.59 vs. 84.43 +/- 13.49, P < 0.05; 6.22 +/- 1.01 vs. 6.40 +/- 0.93, P < 0.05). The difference in Scr in 72 h between the two groups was statistically significant (76.42 +/- 10.92 vs. 79.06 +/- 11.58, P < 0.05). The CIN incidence was significantly lower in the CDDP group than in the hydration group. The CIN risk was significantly elevated in patients with LVEF <50%, contrast volume >= 160 ml, and hypertension, after 48 and 72 h of operation. The serum inflammation index levels NGAL, TNF-alpha, oxidative stress indexes SOD, and MDA significantly differed between the two groups. However, there was no significant difference in serum apoptosis indexes Bax, Bcl-2, and Casepase-9.Conclusions: CDDP pre-treatment could prevent contrast-induced nephropathy. Inflammatory response and oxidative stress could be significant in the CDDP mechanism.

Automated summary

This study aimed to investigate the effectiveness of Compound Danshen dripping pills (CDDP) in preventing contrast-induced nephropathy (CIN) after coronary stent implantation. The study enrolled 411 patients who received CDDP and hydration therapy or hydration only. The results showed that the CIN incidence was significantly lower in the CDDP group. Inflammatory response and oxidative stress may play a significant role in the mechanism of CDDP.