Sodium bicarbonate prophylaxis linked to lower mortality

(HealthDay)—For patients undergoing coronary angiography, sodium bicarbonate prophylaxis for contrast-associated nephropathy (CAN) is associated with reduced long-term mortality, according to research published in the Nov. 15 issue of The American Journal of Cardiology.

Jeremiah R. Brown, Ph.D., from the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire, and colleagues conducted an individual patient data meta-analysis from randomized controlled trials to examine the correlation between sodium bicarbonate prophylaxis for CAN and mortality. Individual patient data sets were obtained for seven of 10 eligible trials and time-to-event data were imputed for the three remaining trials; data were included for 2,764 participants.

The researchers found that sodium bicarbonate correlated with lower mortality than sodium chloride at one year (hazard ratio, 0.61). Periprocedural sodium bicarbonate correlated with reduced incidence of CAN (relative risk, 0.75); for up to one-year mortality, there was a significant interaction between the impact on mortality and occurrence of CAN (hazard ratio, 5.65).

"Periprocedural intravenous sodium bicarbonate seems to be associated with a reduction in long-term mortality in patients undergoing coronary angiography or other intra-arterial interventions," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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