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To the Editor: In their randomized controlled trial, Dr Brar and colleagues¹ found a lack of effectiveness of sodium bicarbonate in preventing CIN compared with saline. This study adds more controversy to the debate about what is the best strategy for CIN prevention. The authors discussed the results of 2 previous randomized trials that showed a remarkable benefit of sodium bicarbonate over saline for the prevention of CIN. However, the authors omitted a number of additional randomized studies evaluating the role of sodium bicarbonate in this setting that should have been taken into account in the discussion.

Recio-Mayoral et al² compared the effect of an infusion of sodium bicarbonate plus N-acetylcysteine vs saline in a group of patients undergoing emergency percutaneous coronary interventions; the incidence of CIN in the former group was 1.8% compared with 21.8% in the group receiving saline (P < .001). In a similar population, Masuda . . . [Full Text of this Article]

Alberto Bouzas-Mosquera, MD
aboumos@canalejo.org

José M. Vázquez-Rodríguez, MD; Jesús Peteiro, MD, PhD
Department of Cardiology
Juan Canalejo Hospital
A Coruña, Spain

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