Prevention of acute kidney injury in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention by quercetine: «case-match-control» study

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O. V. Shumakov
O. M. Parkhomenko
S. M. Kozhukhov
O. O. Sopko

Abstract

The aim – to estimate the effect of intravenous 5-lipoxygenase inhibitor quercetine for prevention of the acute kidney injury (AKI) due to roentgen contrast media usage during percutaneous coronary interventions in patients with ST-elevation myocardial infarction (STEMI).
Material and methods. The retrospective cohort of 254 STEMI patients was studied. All the patients underwent the percutaneous coronary interventions (angiography alone, or followed by angioplastics/stenting) and had serial serum creatinine data. AKI (determined as rise in serum creatinine ≥ 44 μmol/l or ≥ 25 % rise in creatinine over baseline) was present in 40 cases (15.7 %). Then all cases were brought to the automated case-match-control pairing algorithm. Two matched groups of patients were selected: 24 pts were treated with quercetine 500 mg by intravenous infusion immediately before angiography and next 5 days – 500 mg twice daily intravenous (group 1) and 24 pts were controls (group 2). Cases were matched by 7 clinical criteria, including: age, gender, weight, prescription of drugs, which could affect serum creatinine levels (statins, ACE inhibitors, intestinal adsorbents, trimetazidine). Patients with severe congestive heart failure, nephropathy, anemia and systemic hypotension/shock at baseline were excluded.
Results. Incremental dynamics in serum creatinine level was observed in 37.5 % and 56.5 % of group 1 and group 2, respectively (mean 16.8±2.7 % vs 32.3±6.0 % of increase, respectively, Р<0.05). Rate of AKI incidence was 4.2 % in group 1 and 33.3 % in group 2 (Р<0.05). The cumulative rate of 2-10 day non-hemorrhagic adverse events was 45.8 % in group 1 and 91.7 % in group 2 (Р<0.001).
Conclusion. Our data suggest that infusion of 5-lipoxygenase inhibitor quercetine during acute phase of STEMI may prevent the development of AKI and related worsening of STEMI clinical course. This suggestion requires further investigation with larger number of patients in a prospective trial.

Article Details

Keywords:

acute coronary syndrome, acute kidney injury, prevention, quercetine

References

Горошко О.М., Заморський І.І., Геруш О.В. Нефро­­протекторні властивості препаратів кверцетину (корвітин та ліпофлавон) на моделі гентаміцинової нефропатії // Клінічна та експериментальна патологія.– 2009.– № 3 (29).– С. 19–22.

Зупанец И.А., Подпружников Ю.В., Шаламай А.С., Безу­­глая Н.П. Изучение фармакокинетики лекарственного препарата «Корвитин®» // Укр. мед. альманах.– 2011.– Т. 14, № 6.– С. 81–83.

Лапшина Л.А., Золотайкина В.И. Оксидативный стресс при острой сердечной недостаточности и роль антиоксиданта кверцетина в его коррекции // Междунар. мед. журн.– 2009.– Т. 15, № 3.– С. 45–51.

Наказ Міністерства охорони здоров’я № 455 від 02.07.2014 р. Уніфікований клінічний протокол екстреної, первинної, вторинної (спеціалізованої) та третинної (високоспеціалізованої) медичної допомоги та медичної реабілітації хворих на гострий коронарний синдром з елевацією сегмента ST // Серцево-судинні захворювання. Классифікація, стандарти діагностики та лікування / За ред. В.М. Коваленка, М.І. Лутая, Ю.М. Сіренка, О.С. Сичова.– К.: Моріон, 2016.– С. 34–40.

Оспанова Т.С. Фармакологічна корекція дисгоместатичних станів при гломерулонефриті: Автореф. дис. …д. мед. н.– Харків, 1995.– 31 с.

Терещенко С.Н., Ускач Т.М., Рябинина М.И. Современные аспекты кардиоренального синдрома // Журнал сердечная недостаточность.– 2008.– № 5.– С. 226–230.

Al-Shalmani S., Suri S., Hughes D. et al. Quercetin and its principal metabolites, but not myricetin, oppose lipopolysaccharide-induced hyporesponsiveness of the porcine isolated coronary artery // Br. J. Pharmacol.– 2011.– Vol. 162 (7).– P. 1485–1497.

Anjaneyulu M., Сhopra K. Quercetin, an anti-oxidant bioflavonoid, attenuates diabetic nephropathy in rats // Clin. Experiment. Pharmacol. Physiology.– 2004.– Vol. 31 (4).– P. 244–248.

Anwar Y., Sabir J., Qureshi M., Saini K. 5-lipoxygenase: a promising drug target against inflammatory diseases-biochemical and pharmacological regulation // Current Drug Targets.– 2014.– Vol. 15 (4).– P. 410–422.

Bernini R., Crisante F., Ginnasi M. A convenient and safe O-methylation of flavonoids with dimethyl carbonate (DMC) // Molecules.– 2011.– Vol. 16 (2).– P. 1418–1425.

Burgess W., Walker P. Mechanisms of Contrast-Induced Nephropathy Reduction for Saline (NaCl) and Sodium Bicarbonate (NaHCO3) // BioMed. Research International.– 2014.– Vol. 1.– P. 1–6.

Burke J., Dennis E. Phospholipase A2 biochemistry // Cardio­­­vascular Drugs and Therapy.– 2009.– Vol. 23 (1).– P. 49–59.

Cooper D., Claes D., Goldstein S. et al. Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI) // Clin. J. Am. Soc. Nephrol.– 2016.– Vol. 11 (1).– P. 21–29.

Dwyer J., Allayee H., Dwyer K. et al. Arachidonate 5-lipoxygenase promoter genotype, dietary arachidonic acid, and atherosclerosis // The New England Journal of Medicine.– 2004.– Vol. 350 (1).– P. 29–37.

Fang Y., Ding X., Zhong Y. et al. Acute kidney injury in a Chinese hospitalized population // Blood Purif.– 2010.– Vol. 30 (2).– P. 120–126.

Farhan S., Vogel B., Tentzeris I. et al. Contrast induced acute kidney injury in acute coronary syndrome patients: a single centre experience // Eur. Heart J.: Acute Cardiovascular Care.– 2016.– Vol. 5 (I).– P. 55–61.

Francescato H., Coimbra T., Costaatall R. Protective effect of quercetin on the evolution of cisplatin-included acute tubular necrosis // Kidney Blood Pres. Res.–2004.– Vol. 27 (23).– P. 148–158.

Heung M., Chawla L. Acute kidney injury: gateway to chronic kidney disease // Nephron. Clin. Pract.– 2014.– Vol. 127 (1–4).– P. 30–34.

Koza Y. Acute kidney injury: current concepts and new insights // J. Inj. Violence. Res.– 2016.– Vol. 1.– P. 58–62.

Lemmens K., Vrolijk M., Bouwman F. et al. The Minor Structural Difference between the Antioxidants Quercetin and 4′O-Methylquercetin Has a Major Impact on Their Selective Thiol Toxicity // Int. J. Mol. Sci.– 2014.– Vol. 15 (5).– P. 7475–7484.

Leoncini M., Toso A., Maioli M. et al. Early high-dose rosuvastatinfor contrast-induced nephropathy prevention in acute coronary syndrome: results from the PRATO-ACS study (protective effect of rosuvastatin and antiplatelet therapy on contrast-induced acute kidney injury and myocardial damage in patients with acute coronary syndrome) // J. Am. Coll. Cardiol.– 2014.– Vol. 63 (1).– P. 71–79.

Liu H., Guo X., Chu Y., Lu S. Heart protective effects and mechanism of quercetin preconditioning on anti-myocardial ischemia reperfusion (IR) injuries in rats // Gene.– 2014.– Vol. 545 (1).– P. 149–155.

Liu H., Zhang L., Lu S. Evaluation of antioxidant and immunity activities of quercetin in isoproterenol-treated rats // Mole­­cules.– 2012.– Vol. 17 (4).– P. 4281–4291.

Long T., Sigurðsson M., Indridason O., Sigvaldason K., Sigurdsson G. Epidemiology of acute kidney injury in a tertiary care university hospital according to the RIFLE criteria // Laeknabladid.– 2013.– Vol. 99 (11).– P. 499–503.

Nash K., Hafeez A., Hou S. Hospital-acquired renal insufficiency // Am. J. Kidney Dis.– 2002.– Vol. 39.– P. 930–936.

Nicholls S., Wang Z., Koeth R. et al. Metabolic profiling of arginine and nitric oxide pathways predicts hemodynamic abnormalities and mortality in patients with cardiogenic shock after acute myocardial infarction // Circulation.– 2007.– Vol. 116 (20).– P. 2315–2324.

Ochs M., Suess B., Steinhilber D. 5-lipoxygenase mRNA and protein isoforms // Basic & Clinical Pharmacology & Toxicology.– 2014.– Vol. 114 (1).– P. 78–82.

Patel N., Cuzzocrea S., Chatterjee P. et al. Reduction of renal ischemia-reperfusion injury in 5-lipoxygenase knockout mice and by the 5-lipoxygenase inhibitor zileuton // Mol. Pharmacol.– 2004.– Vol. 66 (2).– P. 220–227.

Patti G., Ricottini E., Nusca A. et al. Short-term, high-dose Atorvastatin pretreatment to prevent contrast-inducednephropathy in patients with acute coronary syndromes undergoing percutaneous coronary intervention (from the ARMYDA-CIN [ator­vastatin for reduction of myocardial damage during angioplasty – contrast-induced nephropathy]) trial // Am. J. Cardiol.– 2011.– Vol. 108 (1).– P. 1–7.

Perez-Vizcaino F., Duarte J., Jimenez R. et al. Antihyperten­­sive effects of the flavonoid quercetin // Pharmacol. Rep.– 2009.– Vol. 61 (1).– P. 67–75.

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