Captopril for prevention of Contrast Induced Nephropathy in patients undergoing Coronary Angioplasty: A double blind placebo controlled clinical trial

Contrast induced nephropathy is a potential cause of mortality and morbidity in patients undergoing angiography-angioplasty. Except for hydrating and probably low - isoosmolar contrast agents in high risk groups, other modalities have not provided benefit. We investigated preventive effects of captopril for contrast induced nephropathy during angiography-angioplasty. Methods: In a double blind placebo controlled clinical trial, 88 patients were randomized to two groups : 42 patients received captopril (12.5 mg) every 8 hours from 2 hours before the procedure until 48 hours thereafter, and 46 patients received placebo in the same manner. Serum creatinine was measured before and 48 hours after angioplasty. The data were analy zed by SPSS software, using unpaired student t-test for comparing mean creatinine rise in both groups and paired student t-test for the changes in serum creatinine in each group. Results: The mean creatinine rise in captopril group (0.214 mg/dl) and placebo group (0.226 mg/dl) were not sign ificantly different. The incidence of acute renal failure (creatinine rise more than 0.5 mg/dl) in the captopril (11.9 %) and placebo group (10.8 %) were not significantly different. Conclusion: Captopril does not effecti vely prevent contrast nephropathy, but it is not harmful for rena l function and can be administered safely during ang iography - angioplasty in pat ients with normal renal function. However, the effect of captopril in patients with high- risk characteristics remains to be clarified. Of note , we found a trend for less creatinine rise in diabetics who received captopril during the procedure in comparison to diabet ics who received placebo.