{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T04:02:47Z","timestamp":1744862567388,"version":"3.40.4"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017160","name":"Beni Suef University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017160","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pharmacol Toxicol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>CIN (Contrast-induced Nephropathy) was studied after Percutaneous Coronary Intervention (PCI) or Coronary Angiography (CA). Trimetazidine (TMZ) has been investigated as one of the potential molecules that may protect against CIN by its anti-ischemic, antioxidant, and mitochondrial protective effects. We aimed to observe the reno-protective value of TMZ when added to the Guidelines Directed Medical Therapy (GDMT) in patients receiving contrast.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This cohort observational prospective study included 410 patients with Chronic Coronary Syndrome (CCS) undertaking elective CA or PCI. We observed the kidney function following the non-ionic contrast exposure in Group I (205 patients), who received all the GDMT and TMZ. We compared the results with another Group II (205 patients) who received all the GDMT without TMZ. The primary endpoint was the development of CIN, and the secondary endpoint was follow-up kidney function after one month.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The baseline characteristics of Group I and Group II were similar, with the weighted groups looking very well matched. All Standardized Mean Differences (SMDs) were either below or very close to 0.1.CIN rates at 72\u00a0h were lower in Group I (13.2%) than Group II (22.0%; unadjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.019, Bonferroni-adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.352, FDR-adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.047), suggesting a modest protective effect of TMZ that weakens under stringent correction but remains borderline significant with FDR. By one month, CIN rates were 6.3% in Group I vs. 13.2% in Group II (unadjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.020, Bonferroni-adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.060, FDR-adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.050), reinforcing TMZ\u2019s borderline significant potential long-term benefit.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our Cohort Observational Single-Center study showed that TMZ did not provide robust protection against CIN at 72\u00a0h. However, TMZ may offer a modest, clinically relevant, longer-term renal benefit at one month in patients undergoing elective coronary procedures. Further randomized trials are warranted to validate TMZ\u2019s efficacy and explore its mechanisms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical trial number<\/jats:title>\n            <jats:p>Not applicable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40360-025-00913-3","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T05:06:34Z","timestamp":1744779994000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trimetazidine effect on kidney function in patients undergoing coronary procedures"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6042-9349","authenticated-orcid":false,"given":"Yasser","family":"Abdel-Hady","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9638-7952","authenticated-orcid":false,"given":"Mohammed","family":"Taha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0992-8322","authenticated-orcid":false,"given":"Ahmed","family":"El Barbary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-9720","authenticated-orcid":false,"given":"Osama","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"issue":"6","key":"913_CR1","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1136\/hrt.2006.097477","volume":"93","author":"AO Onbasili","year":"2007","unstructured":"Onbasili AO, Yeniceriglu Y, Agaoglu P, et al. Trimetazidine in the prevention of contrast-induced nephropathy after coronary procedures. Heart. 2007;93(6):698\u2013702.","journal-title":"Heart"},{"issue":"5","key":"913_CR2","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1097\/MAJ.0000000000000575","volume":"350","author":"W Liu","year":"2015","unstructured":"Liu W, Ming Q, Shen J, et al. Trimetazidine prevention of Contrast-Induced nephropathy in coronary angiography. Am J Med Sci. 2015;350(5):398\u2013402.","journal-title":"Am J Med Sci"},{"key":"913_CR3","doi-asserted-by":"publisher","first-page":"174624","DOI":"10.1016\/j.ejphar.2021.174624","volume":"913","author":"K Gupta","year":"2021","unstructured":"Gupta K, Pandey S, Bagang N, et al. Trimetazidine an emerging paradigm in renal therapeutics: preclinical and clinical insights. Eur J Pharmacol. 2021;913:174624.","journal-title":"Eur J Pharmacol"},{"issue":"12","key":"913_CR4","doi-asserted-by":"publisher","first-page":"2267","DOI":"10.1007\/s11255-019-02308-w","volume":"51","author":"X Lian","year":"2019","unstructured":"Lian X, He W, Zhan H, et al. The effect of Trimetazidine on preventing contrast-induced nephropathy after cardiac catheterization. Int Urol Nephrol. 2019;51(12):2267\u201372.","journal-title":"Int Urol Nephrol"},{"issue":"5","key":"913_CR5","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1177\/0267659120952057","volume":"36","author":"X Zhang","year":"2021","unstructured":"Zhang X, Zhang P, Yang S, et al. Preventive effect of Trimetazidine on contrast-induced nephropathy undergoing percutaneous coronary intervention in elderly moderate and high-risk diabetics stratified by Mehran score. Perfusion. 2021;36(5):491\u2013500.","journal-title":"Perfusion"},{"issue":"7","key":"913_CR6","first-page":"3045","volume":"25","author":"JW Martha","year":"2021","unstructured":"Martha JW, Pranata R, Wibowo A, et al. The effect of Trimetazidine on contrast-induced nephropathy in patients undergoing coronary angiography and percutaneous coronary intervention\u2013 A systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2021;25(7):3045\u201353.","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"22","key":"913_CR7","doi-asserted-by":"publisher","first-page":"2616","DOI":"10.1001\/jama.291.22.2616","volume":"291","author":"DT Mangano","year":"2004","unstructured":"Mangano DT, Layug EL, Wallace A, et al. The effect of perioperative intravenous hydration on renal dysfunction after coronary artery bypass graft surgery: a randomized trial. JAMA. 2004;291(22):2616\u201323. https:\/\/doi.org\/10.1001\/jama.291.22.2616.","journal-title":"JAMA"},{"issue":"9","key":"913_CR8","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1016\/j.jacc.2004.07.016","volume":"44","author":"C Briguori","year":"2004","unstructured":"Briguori C, Visconti G, Focaccio A, et al. N-acetylcysteine for prevention of contrast-induced nephropathy in high-risk patients undergoing coronary angiography: a randomized trial. J Am Coll Cardiol. 2004;44(9):1743\u20139. https:\/\/doi.org\/10.1016\/j.jacc.2004.07.016.","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"913_CR9","doi-asserted-by":"publisher","first-page":"379","DOI":"10.5414\/CNP88D199","volume":"89","author":"C Cevik","year":"2018","unstructured":"Cevik C, Erdem G, Sekercioglu S, et al. The effect of Trimetazidine on contrast-induced nephropathy in patients with cardiovascular disease. Clin Nephrol. 2018;89(6):379\u201385. https:\/\/doi.org\/10.5414\/CNP88D199.","journal-title":"Clin Nephrol"},{"issue":"36","key":"913_CR10","doi-asserted-by":"publisher","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","volume":"45","author":"C Vrints","year":"2024","unstructured":"Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024;45(36):3415\u2013537. https:\/\/doi.org\/10.1093\/eurheartj\/ehae177.","journal-title":"Eur Heart J"},{"issue":"10","key":"913_CR11","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1055\/a-1180-4357","volume":"70","author":"T K\u00f6rnicke","year":"2020","unstructured":"K\u00f6rnicke T, Arora D, Samad A, et al. Single ascending dose study to assess Pharmacokinetic linearity, safety, and tolerability of Trimetazidine - Modified release in healthy human subjects. Drug Res (Stuttg). 2020;70(10):472\u20137. https:\/\/doi.org\/10.1055\/a-1180-4357.","journal-title":"Drug Res (Stuttg)"},{"issue":"5","key":"913_CR12","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1002\/ddr.21654","volume":"81","author":"N Nenchev","year":"2020","unstructured":"Nenchev N, Skopek J, Arora D, et al. Effect of age and renal impairment on the pharmacokinetics and safety of Trimetazidine: an open-label multiple-dose study. Drug Dev Res. 2020;81(5):564\u201372.","journal-title":"Drug Dev Res"},{"issue":"1","key":"913_CR13","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s40001-018-0320-2","volume":"23","author":"F Chen","year":"2018","unstructured":"Chen F, Liu F, Lu J, et al. Coenzyme Q10 combined with Trimetazidine in preventing contrast-induced nephropathy in patients with coronary heart disease complicated with renal dysfunction undergoing elective cardiac catheterization: a randomized control study and in vivo study. Eur J Med Res. 2018;23(1):23.","journal-title":"Eur J Med Res"},{"issue":"5","key":"913_CR14","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.carrev.2017.02.006","volume":"18","author":"TA Ibrahim","year":"2017","unstructured":"Ibrahim TA, El-Mawardy RH, El-Serafy AS, et al. Trimetazidine in the prevention of contrast-induced nephropathy in chronic kidney disease. Cardiovasc Revasc Med. 2017;18(5):315\u20139.","journal-title":"Cardiovasc Revasc Med"},{"issue":"2","key":"913_CR15","first-page":"292","volume":"21","author":"MM Rahman","year":"2012","unstructured":"Rahman MM, Haque SS, Rokeya B, et al. Trimetazidine in the prevention of contrast-induced nephropathy after the coronary angiogram. Mymensingh Med J. 2012;21(2):292\u20139.","journal-title":"Mymensingh Med J"},{"issue":"1","key":"913_CR16","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1159\/000180580","volume":"16","author":"DW Cockcroft","year":"1976","unstructured":"Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31\u201341.","journal-title":"Nephron"},{"key":"913_CR17","doi-asserted-by":"publisher","first-page":"e20200161","DOI":"10.1590\/1677-5449.200161","volume":"20","author":"AB Moro","year":"2021","unstructured":"Moro AB, Strauch JGN, Groto AD, et al. Creatinine level variation in patients subjected to contrast-enhanced tomography: a meta-analysis. J Vasc Bras. 2021;20:e20200161. https:\/\/doi.org\/10.1590\/1677-5449.200161.","journal-title":"J Vasc Bras"},{"issue":"2","key":"913_CR18","doi-asserted-by":"publisher","first-page":"143","DOI":"10.2165\/00129784-200707020-00006","volume":"7","author":"A Labrou","year":"2007","unstructured":"Labrou A, Giannoglou G, Zioutas D, et al. Trimetazidine administration minimizes myocardial damage and improves left ventricular function after percutaneous coronary intervention. Am J Cardiovasc Drugs. 2007;7(2):143\u201350.","journal-title":"Am J Cardiovasc Drugs"},{"key":"913_CR19","unstructured":"Modi K, Padala SA, Gupta M, Contrast-Induced N. (2023) In: StatPearls, editor. Treasure Island (FL): StatPearls Publishing."},{"issue":"2","key":"913_CR20","first-page":"85","volume":"37","author":"K Makris","year":"2016","unstructured":"Makris K, Spanou L. Acute kidney injury: definition, pathophysiology and clinical phenotypes. Clin Biochem Rev. 2016;37(2):85\u201398.","journal-title":"Clin Biochem Rev"},{"issue":"6","key":"913_CR21","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1007\/s13244-013-0291-3","volume":"4","author":"RW Geenen","year":"2013","unstructured":"Geenen RW, Kingma HJ, van der Molen AJ. Contrast-induced nephropathy: pharmacology, pathophysiology, and prevention. Insights Imaging. 2013;4(6):811\u201320.","journal-title":"Insights Imaging"},{"issue":"12","key":"913_CR22","doi-asserted-by":"publisher","first-page":"695","DOI":"10.4070\/kcj.2011.41.12.695","volume":"41","author":"SH Jo","year":"2011","unstructured":"Jo SH. N-acetylcysteine for prevention of Contrast-Induced nephropathy: A narrative review. Korean Circ J. 2011;41(12):695\u2013702.","journal-title":"Korean Circ J"},{"issue":"2","key":"913_CR23","doi-asserted-by":"publisher","first-page":"33","DOI":"10.4103\/1995-705X.137489","volume":"15","author":"K Mahmoodi","year":"2014","unstructured":"Mahmoodi K, Sohrabi B, Ilkhchooyi F, et al. The efficacy of hydration with normal saline versus hydration with sodium bicarbonate in the prevention of Contrast-induced nephropathy. Heart Views. 2014;15(2):33\u20136.","journal-title":"Heart Views"},{"key":"913_CR24","doi-asserted-by":"publisher","first-page":"e1876","DOI":"10.6061\/clinics\/2021\/e1876","volume":"76","author":"YL Zhou","year":"2021","unstructured":"Zhou YL, Chen LQ, Du XG. Efficacy of short-term moderate or high-dose Statin therapy for the prevention of contrast-induced nephropathy in high-risk patients with chronic kidney disease: systematic review and meta-analysis. Clin (Sao Paulo). 2021;76:e1876.","journal-title":"Clin (Sao Paulo)"},{"issue":"3","key":"913_CR25","doi-asserted-by":"publisher","first-page":"e871","DOI":"10.1097\/MJT.0000000000000180","volume":"23","author":"CA D\u00e9zsi","year":"2016","unstructured":"D\u00e9zsi CA. Trimetazidine in practice: review of the clinical and experimental evidence. Am J Ther. 2016;23(3):e871\u20139.","journal-title":"Am J Ther"},{"issue":"4","key":"913_CR26","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1055\/s-0030-1267860","volume":"27","author":"RK Gupta","year":"2010","unstructured":"Gupta RK, Bang TJ. Prevention of Contrast-Induced nephropathy (CIN) in interventional radiology practice. Semin Intervent Radiol. 2010;27(4):348\u201359.","journal-title":"Semin Intervent Radiol"},{"key":"913_CR27","doi-asserted-by":"crossref","unstructured":"Sadat U. Radiographic contrast-media-induced acute kidney injury: pathophysiology and prophylactic strategies. ISRN Radiol 2013;496438.","DOI":"10.5402\/2013\/496438"},{"issue":"24","key":"913_CR28","doi-asserted-by":"publisher","first-page":"e25823","DOI":"10.1097\/MD.0000000000025823","volume":"100","author":"Y Liu","year":"2021","unstructured":"Liu Y, Jiang J, Wu Y, et al. Trimetazidine for preventing contrast-induced nephropathy in patients with renal insufficiency: a systematic review and meta-analysis. Med (Baltim). 2021;100(24):e25823. https:\/\/doi.org\/10.1097\/MD.0000000000025823.","journal-title":"Med (Baltim)"},{"issue":"1","key":"913_CR29","first-page":"35","volume":"20","author":"J Albright","year":"2020","unstructured":"Albright J, Moussa I, Criscione J, et al. The effect of Trimetazidine in preventing contrast-induced nephropathy in high-risk patients undergoing coronary angiography: a meta-analysis of randomized controlled trials. Ochsner J. 2020;20(1):35\u201341.","journal-title":"Ochsner J"},{"issue":"5","key":"913_CR30","first-page":"1234","volume":"41","author":"L Zhang","year":"2023","unstructured":"Zhang L, Wang Y, Li J, et al. Comparative efficacy of Temozolomide versus nephroprotective agents in chemotherapy-induced nephrotoxicity: a meta-analysis. J Clin Oncol. 2023;41(5):1234\u201345.","journal-title":"J Clin Oncol"},{"issue":"4","key":"913_CR31","first-page":"675","volume":"89","author":"J Smith","year":"2022","unstructured":"Smith J, Doe R, Lee Y. Comparative efficacy of Temozolomide and nephroprotective agents in cancer patients: a prospective cohort study. Cancer Chemother Pharmacol. 2022;89(4):675\u201383.","journal-title":"Cancer Chemother Pharmacol"},{"issue":"4","key":"913_CR32","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1016\/j.kint.2018.04.002","volume":"94","author":"L Zhao","year":"2018","unstructured":"Zhao L, Wang G, Jiang W, et al. Trimetazidine protects renal tubular cells from contrast-induced nephropathy by regulating mitochondrial function and oxidative stress. Kidney Int. 2018;94(4):723\u201331. https:\/\/doi.org\/10.1016\/j.kint.2018.04.002.","journal-title":"Kidney Int"},{"issue":"5","key":"913_CR33","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1111\/nep.13601","volume":"25","author":"L Zhao","year":"2020","unstructured":"Zhao L, Li P, Zhang Y, et al. Trimetazidine prevents contrast-induced kidney injury via stabilization of hypoxia-inducible factor-1\u03b1 and Inhibition of apoptosis. Nephrol (Carlton). 2020;25(5):427\u201336. https:\/\/doi.org\/10.1111\/nep.13601.","journal-title":"Nephrol (Carlton)"}],"container-title":["BMC Pharmacology and Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40360-025-00913-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40360-025-00913-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40360-025-00913-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T05:06:37Z","timestamp":1744779997000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpharmacoltoxicol.biomedcentral.com\/articles\/10.1186\/s40360-025-00913-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,16]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["913"],"URL":"https:\/\/doi.org\/10.1186\/s40360-025-00913-3","relation":{},"ISSN":["2050-6511"],"issn-type":[{"value":"2050-6511","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,16]]},"assertion":[{"value":"4 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We conducted the study protocol following the Declaration of Helsinki. The Committee of Research and Ethics of Beni-Suef University approved the study protocol on the 7th of June 2022, Approval FMBSUREC\/07062022\/TAHA. In addition, all the patients signed informed written consent to participate.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"85"}}