NITRATE-CIN

Read the papers:

1. Inorganic nitrate benefits contrast-induced nephropathy after coronary angiography for acute coronary syndromes: the NITRATE-CIN trial
2. Local delivery of nitric oxide prevents endothelial dysfunction in periodontitis
3. Inorganic nitrate improves safety of coronary angiography in patients at renal injury risk
4. NITRATE-CIN Study: Protocol of a Randomized (1:1) Single-Center, UK, Double-Blind Placebo-Controlled Trial Testing the Effect of Inorganic Nitrate on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography for Acute Coronary Syndromes

Full Title: The Effect of Inorganic Nitrate on Contrast-Induced Nephropathy in Patients undergoing Coronary Angiography/Percutaneous Coronary Intervention for Acute Coronary Syndrome (ACS): A randomised single-centre, double-blind placebo-controlled trial

Short Title: NITRATE-CIN

Sponsor: Queen Mary University of London

Funder: Heart Research UK

Chief Investigator: Prof Amrita Ahluwalia, Professor of Vascular Pharmacology, Dean for Research, Queen Mary University of London & Director of Barts CVCTU

Co-Investigators: Dr Dan Jones, Consultant Cardiologist, Barts Health NHS Trust; Anne-Marie Beirne, Sub-Investigator, Barts Health NHS Trust

Contact: daniel.jones@qmul.ac.uk (PI)

Registration: https://www.clinicaltrials.gov/study/NCT03627130

Study Design: Randomised, double-blind, placebo-controlled single-centre trial

Objectives:

• To determine whether inorganic nitrate therapy reduces the incidence of contrast-induced nephropathy (CIN) in ACS patients undergoing coronary angiography ± PCI
• To assess the impact of nitrate therapy on persistent renal impairment at 3-month follow-up

Number of Participants: 640

Intervention Used: Dietary inorganic nitrate

Study Duration: 3 years

Location: Barts Heart Centre, London

Summary: Contrast-induced nephropathy (CIN) is a type of acute kidney injury that can occur after exposure to iodinated contrast media during coronary angiographic procedures, especially in high-risk patients. Despite preventive strategies, there is still a need for an effective intervention to reduce the risk of CIN. This study is based on evidence that contrast dye may cause kidney damage by reducing levels of nitric oxide (NO) in the kidneys. Inorganic nitrate, through its conversion to NO in the body, has shown potential in mitigating this damage.

The NITRATE-CIN trial is a single-centre, randomised, double-blind, placebo-controlled study evaluating whether dietary inorganic nitrate can reduce CIN in patients with acute coronary syndromes undergoing coronary angiography or PCI. Participants will be assigned to either dietary nitrate or placebo. The primary outcome is the development of CIN according to KDIGO criteria. A key secondary outcome is long-term renal function measured over a 3-month follow-up period. The results could inform future guidelines on the management of CIN in this patient population.