Methods
hypoalbuminemia, CKD, allergy, diseases like liver cirrhosis, ’ stage 3, acute coronary syndrome, heart failure
HYPOALBUMINEMIA, ALLERGY, HEMODYNAMIC INSTABILITY, ACUTE CORONARY SYNDROME, CKD STAGE 3, HEART FAILURE
In a randomized controlled trial, we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting starting from 25 to 2022 to the second of September 2022. This study was performed in accordance with the ethical standards of Ain Shams University Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ain Shams University Faculty of Medicine Research Ethics Committee (REC) FWA 000017585 has approved the study protocol with approval number (MS 616/2020). The clinical trial registration number is NCT05264584, and the first date of registration was 03/03/2022. An informed consent was obtained from the included patients. All included patients met the inclusion criteria; were older than 18 years old, CKD patients’ stage 3, under treatment of high dose statin; Atorvastatin (40–80 mg/day) and undergoing PCI. Patients with known allergy to febuxostat or under treatment with uric acid-lowering medications (allopurinol- febuxostat-benzbromarone) and patients with severe debilitating diseases like liver cirrhosis, hypoalbuminemia or heart failure were excluded. Patients who developed hemodynamic instability periprocedurally, also were excluded from our study. In addition, those patients who underwent high osmolar contrast media during the procedure were also excluded. All patients received low osmolar contrast media and IV hydration in the form of a continuous intravenous infusion of isotonic saline at a rate of 0.5 mL/kg/h for at least 2 to 12 h before the procedure and lasted for 6 to 24 h afterward. They also received N-acetylcysteine 600 mg orally twice daily on the day before and the day of exposure to contrast or a single periprocedural dose (1200 mg, within 4 h of contrast exposure). Patients were randomly assigned to two arms.