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Cardiology Research and Practice
Volume 2015 (2015), Article ID 690308, 16 pages
http://dx.doi.org/10.1155/2015/690308
Review Article

Current Status of Sodium Bicarbonate in Coronary Angiography: An Updated Comprehensive Meta-Analysis and Systematic Review

1Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2Department of Medicine III, University of Heidelberg, Heidelberg, Germany
3Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, London, UK

Received 4 November 2014; Accepted 25 March 2015

Academic Editor: Frans Leenen

Copyright © 2015 Sadegh Ali-Hassan-Sayegh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes. We searched major electronic databases for studies in randomized controlled trials. A value of for Q test or % indicated significant heterogeneity between the studies. Literature search of all databases retrieved 650 studies. 29 studies enrolled in meta-analysis. Pooled analysis indicated about the incidence of CIN (OR of 0.718; 95% CI: 0.60 to 0.85; ), requirement of hemodialysis (OR of 1.00; 95% CI: 0.49 to 2.01; ), mean changes of serum creatinine (WMD of 2.321; 95% CI: 1.995 to 2.648; ), length of hospital stays (WMD of −0.774; 95% CI: −1.65 to 0.10; ), major adverse cardiovascular events (OR = 1.075, 95% CI: 0.59 to 1.95; ), and mortality (OR of 0.73; 95% CI: 0.42 to 1.26; ). Overall, hydration with sodium bicarbonate could significantly reduce CIN and the length of hospital stay compared to sodium chloride. In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.