Contrast-induced nephropathy (CIN) is a common complication of percutaneous coronary intervention (PCI). Increased release of adenosine and stimulation of adenosine receptors have been proposed to be major mechanisms in the development of CIN. This study aimed to investigate the efficacy of theophylline in patients with chronic stable angina (CSA) undergoing elective PCI. Fifty nine patients with stable serum creatinine and having moderate or high risk for CIN were randomized to three groups: Group I (20 patients received IV hydration 1 ml/kg/hr for 24 hours plus N-acetylcysteine 600 mg bid two days before PCI), Group II: (19 patients received IV hydration 1ml/kg/hr for 24 hours plus theophylline 200 mg in 100 ml 0.9% saline, as IV infusion 30 minutes before PCI) and Group III (20 patients received IV hydration 1 ml/kg/hr for 24 hours plus NAC 600 mg bid two days before PCI plus theophylline 200 mg in 100 ml 0.9% saline, as IV infusion 30 minutes before PCI). The primary goal was assessment of CIN. The secondary goal was assessment ability of neutrophil-gelatinase associated lipocaline (NGAL) in early detection of CIN. The incidence of CIN was significantly lower in group III compared with other groups. NGAL Sensitivity was 100%, specificity was 80% and area under the curve=0.92. In conclusion, use of theophylline plus NAC in patients undergoing elective PCI lead to decrease the incidence of CIN.NGAL is an early biomarker that depicts CIN.
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