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Meta-Analysis of Individual Patient Data of Sodium Bicarbonate and Sodium Chloride for All-Cause Mortality After Coronary Angiography.

  • Brown JR The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Community and Family Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Electronic address: jbrown@dartmouth.edu.
  • Pearlman DM The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
  • Marshall EJ The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
  • Alam SS The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
  • MacKenzie TA The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Community and Family Medicine, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
  • Recio-Mayoral A Department of Cardiology, Virgen Macarena University Hospital, Seville, Spain.
  • Gomes VO Hospital São Lucas, PUCRS, Porto Alegre, Rio Grande do Sul, Brazil.
  • Kim B The Dartmouth Institute for Health Policy and Clinical Practice, Audrey and Theodor Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
  • Jensen LO Department of Cardiology, Odense University Hospital, Odense, Denmark.
  • Mueller C Department of Cardiology, University Hospital Basel, Petersgraben, Switzerland.
  • Maioli M Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy.
  • Solomon RJ Fletcher Allen Health Care, University of Vermont School of Medicine, Burlington, Vermont.
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  • 2016-09-20
Published in:
  • The American journal of cardiology. - 2016
Cause of Death
Contrast Media
Coronary Angiography
Coronary Artery Disease
Global Health
Glomerular Filtration Rate
Humans
Incidence
Infusions, Intravenous
Renal Insufficiency, Chronic
Sodium Bicarbonate
Sodium Chloride
Survival Rate
English We sought to examine the relation between sodium bicarbonate prophylaxis for contrast-associated nephropathy (CAN) and mortality. We conducted an individual patient data meta-analysis from multiple randomized controlled trials. We obtained individual patient data sets for 7 of 10 eligible trials (2,292 of 2,764 participants). For the remaining 3 trials, time-to-event data were imputed based on follow-up periods described in their original reports. We included all trials that compared periprocedural intravenous sodium bicarbonate to periprocedural intravenous sodium chloride in patients undergoing coronary angiography or other intra-arterial interventions. Included trials were determined by consensus according to predefined eligibility criteria. The primary outcome was all-cause mortality hazard, defined as time from randomization to death. In 10 trials with a total of 2,764 participants, sodium bicarbonate was associated with lower mortality hazard than sodium chloride at 1 year (hazard ratio 0.61, 95% confidence interval [CI] 0.41 to 0.89, p = 0.011). Although periprocedural sodium bicarbonate was associated with a reduction in the incidence of CAN (relative risk 0.75, 95% CI 0.62 to 0.91, p = 0.003), there exists a statistically significant interaction between the effect on mortality and the occurrence of CAN (hazard ratio 5.65, 95% CI 3.58 to 8.92, p <0.001) for up to 1-year mortality. Periprocedural intravenous sodium bicarbonate seems to be associated with a reduction in long-term mortality in patients undergoing coronary angiography or other intra-arterial interventions.
Language
  • English
Open access status
green
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Persistent URL
https://sonar.ch/global/documents/273150
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