Brown, Jeremiah RPearlman, Daniel MMarshall, Emily JAlam, Shama SMacKenzie, Todd ARecio-Mayoral, AlejandroGomes, Vitor OKim, BokyungJensen, Lisette OMueller, ChristianMaioli, MauroSolomon, Richard J2023-01-252023-01-252016-08-24http://hdl.handle.net/10668/10456We sought to examine the relation between sodium bicarbonate prophylaxis for contrast-associated nephropathy (CAN) and mortality. We conducted an individual patient data meta-analysis from multiple randomized controlled trials. We obtained individual patient data sets for 7 of 10 eligible trials (2,292 of 2,764 participants). For the remaining 3 trials, time-to-event data were imputed based on follow-up periods described in their original reports. We included all trials that compared periprocedural intravenous sodium bicarbonate to periprocedural intravenous sodium chloride in patients undergoing coronary angiography or other intra-arterial interventions. Included trials were determined by consensus according to predefined eligibility criteria. The primary outcome was all-cause mortality hazard, defined as time from randomization to death. In 10 trials with a total of 2,764 participants, sodium bicarbonate was associated with lower mortality hazard than sodium chloride at 1 year (hazard ratio 0.61, 95% confidence interval [CI] 0.41 to 0.89, p = 0.011). Although periprocedural sodium bicarbonate was associated with a reduction in the incidence of CAN (relative risk 0.75, 95% CI 0.62 to 0.91, p = 0.003), there exists a statistically significant interaction between the effect on mortality and the occurrence of CAN (hazard ratio 5.65, 95% CI 3.58 to 8.92, penCause of DeathContrast MediaCoronary AngiographyCoronary Artery DiseaseGlobal HealthGlomerular Filtration RateHumansIncidenceInfusions, IntravenousRenal Insufficiency, ChronicSodium BicarbonateSodium ChlorideSurvival Rateresearch article27642111open access10.1016/j.amjcard.2016.08.0081879-1913PMC6579735https://europepmc.org/articles/pmc6579735?pdf=renderhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579735/pdf