Coenzyme Q10 in Prevention of Contrast-induced Nephropathy in Patients with Acute Coronary Syndrome Undergoing Coronary Angiography

Background and Aim: Contrast-induced nephropathy (CIN) is a serious complication of coronary angiography (CA), associated with increased morbidity and mortality.Coenzyme Q10 (CoQ10), an endogenous antioxidant, has shown promise in mitigating oxidative renal injury.This study investigated CoQ10's protective effect against CIN in acute coronary syndrome (ACS) cases undergoing CA. Materials and Methods:In a prospective randomized clinical trial (registration number: NCT06429345, date: 19.03.2024), 300 ACS cases were enrolled between March and September 2024.Cases were randomized into a CoQ10 group (n=200) receiving oral CoQ10 and a control group (n=100) receiving standard care.Serum creatinine, estimated glomerular filtration rate (eGFR), and urine output were monitored for three days post-procedure.CIN was defined as a 0.5 mg/dL or 25% increase in serum creatinine or a 25% decline in eGFR within 48 hours.Results: CIN incidence was significantly lower in the CoQ10 group (9%) compared to controls (21%) (P = 0.004).Postoperative serum creatinine levels were markedly lower, and eGFR notably higher, in the CoQ10 group on days two and three (P < 0.01).Multivariate logistic regression identified high body mass index [odds ratio (OR) =6.976, P < 0.001], chronic kidney disease (OR =6.288, P = 0.001), and balloon dilatation (OR =3.116, P = 0.012) as independent predictors of CIN. Conclusion:CoQ10 supplementation significantly reduced CIN incidence in ACS cases undergoing CA.CoQ10's antioxidative and antiinflammatory properties support its potential as a safe adjunctive therapy for CIN prevention.