Probucol for the prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography or percutaneous coronary intervention: A meta-analysis of randomized controlled trials

Background: The results of pilot randomized controlled trials (RCTs) evaluating probucol treatment on the risk of contrast-induced acute kidney injury (CI-AKI) are inconsistent. We aimed to perform a meta-analysis of RCTs to systematically evaluate the influence of probucol on the incidence of CI-AKI. Materials and methods: Related RCTs were identified via searching of PubMed, Embase, and Cochrane's Library databases. Results were pooled using a random-effect model or a fixed-effect model according to the heterogeneity. Results: Five RCTs with 1,367 patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) were included. Meta-analysis indicated that probucol in addition to periprocedural hydration significantly reduced the incidence of CI-AKI (risk ratio (RR): 0.37, 95% confidence interval (CI): 0.24 - 0.56, p < 0.001) with insignificant heterogeneity (I-2 = 0%). Moreover, treatment with probucol significantly lowered the increment of serum creatinine (weighted mean difference (WMD): -0.04 mg/dL, 95% CI: -0.07 to -0.02 mg/dL, p < 0.001) and preserved the loss of estimated glomerular filtrating rate (WMD: 2.46 mL/min, 95% CI: 0.84 - 4.07 mL/min, p = 0.003) as compared with control treatment. No significant publication bias was noticed. Conclusion: Treatment with probucol reduces the incidence of CI-AKI in patients undergoing contrast exposure during CAG or PCI. The influence of probucol on the clinical outcome in these patients deserves further investigation.