Prevention of Serious Adverse Events Following Angiography (PRESERVE)
Acute Renal Failure, Kidney Disease, Coronary Artery Disease
About this trial
This is an interventional prevention trial for Acute Renal Failure focused on measuring renal, cardiovascular, kidney, heart, clinical trial, double-blind, multi-site trial, randomized, drug treatment, IV solutions, antioxidant
Eligibility Criteria
Inclusion Criteria:
- Planned elective or urgent coronary or non-coronary angiography with iodinated contrast media in which it is anticipated that there will be an interval of 3 hours between the identification of the indication for angiography and the time of the planned procedure.
- Pre-angiography eGFR <60 ml/min/1.73 m2 with diabetes mellitus or pre-angiography eGFR <45 ml/min/1.73 m2 with or without diabetes mellitus
- Ability to provide informed consent
Exclusion Criteria:
- Stage 5 chronic kidney disease (CKD) (eGFR <15 mL/min/1.73 m2)
- Currently receiving hemodialysis, peritoneal dialysis, continuous renal replacement therapy, or sustained low efficiency dialysis (SLED)
- Unstable baseline serum creatinine (SCr) (if known) at the time of angiography defined by an increase in SCr of 25% over the 3 days prior to angiography
Decompensated heart failure requiring any of the following therapies at the time of angiography:
- IV milrinone, amrinone, dobutamine, or nesiritide
- Isolated ultrafiltration therapy
- Intra-aortic balloon pump
- Emergent angiography procedures defined as an anticipated duration of <3 hours between the identification of the indication for angiography and the time of the planned procedure.
- Receipt of intravascular iodinated contrast within the 5 days preceding angiography
- Receipt of oral or IV NAC within the 48 hours preceding angiography
- Known allergy to N-acetylcysteine (NAC)
- Known anaphylactic allergy to iodinated contrast media
- Prisoner
- Age <18 years
- Pregnancy
- Ongoing participation in an unapproved concurrent interventional study
Sites / Locations
- Southern Arizona VA Health Care System, Tucson
- Central Arkansas VHS John L. McClellan Memorial Veterans Hospital, Little Rock, AR
- VA Palo Alto Health Care System, Palo Alto, CA
- San Francisco VA Medical Center, San Francisco, CA
- VA Greater Los Angeles Healthcare System, West Los Angeles, CA
- Bay Pines VA Healthcare System, Pay Pines, FL
- North Florida/South Georgia Veterans Health System, Gainesville, FL
- Charlie Norwood VA Medical Center, Augusta, GA
- Atlanta VA Medical and Rehab Center, Decatur, GA
- Jesse Brown VA Medical Center, Chicago, IL
- Richard L. Roudebush VA Medical Center, Indianapolis, IN
- VA Boston Healthcare System West Roxbury Campus, West Roxbury, MA
- VA Ann Arbor Healthcare System, Ann Arbor, MI
- Minneapolis VA Health Care System, Minneapolis, MN
- Kansas City VA Medical Center, Kansas City, MO
- St. Louis VA Medical Center John Cochran Division, St. Louis, MO
- New Mexico VA Health Care System, Albuquerque, NM
- VA Western New York Healthcare System, Buffalo, NY
- Manhattan Campus of the VA NY Harbor Healthcare System, New York, NY
- Durham VA Medical Center, Durham, NC
- Cincinnati VA Medical Center, Cincinnati, OH
- Louis Stokes VA Medical Center, Cleveland, OH
- Dayton VA Medical Center, Dayton, OH
- Oklahoma City VA Medical Center, Oklahoma City, OK
- Portland VA Medical Center, Portland, OR
- VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA
- Ralph H. Johnson VA Medical Center, Charleston, SC
- Memphis VA Medical Center, Memphis, TN
- VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX
- Michael E. DeBakey VA Medical Center, Houston, TX
- South Texas Health Care System, San Antonio, TX
- VA Salt Lake City Health Care System, Salt Lake City, UT
- Hunter Holmes McGuire VA Medical Center, Richmond, VA
- Salem VA Medical Center, Salem, VA
- VA Puget Sound Health Care System Seattle Division, Seattle, WA
- Canberra Hospital
- Concord Hospital
- Gosford Hospital
- Nepean Hospital
- St. George Hospital
- Liverpool Hospital
- Royal North Shore Hospital
- Flinders Medical Centre
- Northern Health
- Austin Health
- Fremantle Hospital
- Sir Charles Gairdner Hospital
- Royal Perth Hospital
- Penang Hospital
- Hospital Serdang
- University of Malaya Medical Center
- Taranaki Base Hospital
- Wellington Hospital
- Auckland City Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Saline & oral placebo
Saline & oral N-acetylcysteine
Bicarbonate & oral placebo
Bicarbonate & oral N-acetylcysteine
IV isotonic saline and oral placebo drug capsule
IV isotonic saline and oral N-acetylcysteine drug capsule
IV isotonic bicarbonate and oral placebo drug capsule
IV isotonic bicarbonate and oral N-acetylcysteine drug capsule