• Yousef Rezaei, Kamal Khademvatani, Behzad Rahimi, Mehran Khoshfetrat, Nasim Arjmand, and Mir-Hossein Seyyed-Mohammadzad.
• Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran yousefrezaei1986@gmail.com hmohammadzad@gmail.com.
• J Am Heart Assoc. 2016 Mar 15; 5 (3): e002919.

BackgroundContrast medium-induced acute kidney injury (CIAKI) is a leading cause of acquired renal impairment. The effects of antioxidants have been conflicting regarding the prevention of CIAKI. We performed a study of vitamin E use to decrease CIAKI in patients undergoing elective coronary angiography.Methods And ResultsIn a placebo-controlled randomized trial at 2 centers in Iran, 300 patients with chronic kidney disease-defined as estimated glomerular filtration rate <60 mL/min per 1.73 m(2)-were randomized 1:1 to receive 0.9% saline infusion 12 hours prior to and after intervention combined with 600 mg vitamin E 12 hours before plus 400 mg vitamin E 2 hours before coronary angiography or to receive placebo. The primary end point was the development of CIAKI, defined as an increase ≥0.5 mg/dL or ≥25% in serum creatinine that peaked within 72 hours. Based on an intention-to-treat analysis, CIAKI developed in 10 (6.7%) and 21 (14.1%) patients in the vitamin E and placebo groups, respectively (P=0.037). Change in white blood cell count from baseline to peak value was greater in the vitamin E group compared with the placebo group (-500 [-1500 to 200] versus 100 [-900 to 600]×10(3)/mL, P=0.001). In multivariate analysis, vitamin E (odds ratio 0.408, 95% CI 0.170-0.982, P=0.045) and baseline Mehran score (odds ratio 1.257, 95% CI 1.007-1.569; P=0.043) predicted CIAKI.ConclusionsProphylactic short-term high-dose vitamin E combined with 0.9% saline infusion is superior to placebo for prevention of CIAKI in patients undergoing elective coronary angiography.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov/. Unique identifier: NCT02070679.© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

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