Coronary disease & ACS

Inorganic nitrate benefits contrast-induced nephropathy after coronary angiography for acute coronary syndromes: the NITRATE-CIN trial

Eur Heart JPublished Randomised controlled trial

Primary result · CINResult — go to the resultOdds ratio 0.21 95% CI 0.13–0.34

Authors' conclusion

In patients at risk of renal injury undergoing coronary angiography for ACS, a short (5 day) course of once-daily inorganic nitrate reduced CIN, improved kidney outcomes at 3 months, and MACE events at 1 year compared to placebo.

Study context

Population
At-risk patients with acute coronary syndromes (ACS) undergoing coronary angiographymedian follow-up 1.0 years
Participants
640 patients
Comparison
Inorganic nitrate vs placebo
  • Inorganic nitraten = 319
  • Placebon = 321reference
Primary endpoint
Contrast-induced nephropathy (KDIGO criteria)
Methodological detailsdouble-blind, placebo-controlled, single-centre
  • Double-blind
  • Placebo-controlled
  • Single-centre

Primary result

Contrast-induced nephropathy (CIN)

Odds ratio

0.21

95% CI 0.13–0.34

P < 0.001

By group

Inorganic nitratevs Placebo
OR 0.21 (95% CI 0.13–0.34); P < 0.001

As reported in the abstract

Secondary outcomes

Procedural MI

P = 0.003

OutcomeBetween-group change in eGFR (95% CI)
Change in eGFR · 3 months5.17 (2.94–7.39)
OutcomeInorganic nitratePlaceboP value
MACE · 1 year— not stated in the abstract18.1%P = 0.001

— not stated in the abstract

Original publication

Inorganic nitrate benefits contrast-induced nephropathy after coronary angiography for acute coronary syndromes: the NITRATE-CIN trial. Eur Heart J. Published 21 March 2024. doi:10.1093/eurheartj/ehae100

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