Abstract:
OBJECTIVES:The aim of this randomized, single-blind, controlled trial was to assess N-acetylcysteine effects on contrast-induced nephropathy and reperfusion injury in ST-segment elevation myocardial infarction patients undergoing primary angioplasty with moderate contrast volumes. BACKGROUND:High-dose N-acetylcysteine reduced the incidence of contrast-induced nephropathy in patients with high contrast volumes and reduced reperfusion injury in animal trials. METHODS:Patients undergoing primary angioplasty were randomized to either high-dose N-acetylcysteine (2 x 1,200 mg/day for 48 h; n = 126) or placebo plus optimal hydration (n = 125). The 2 primary end points were: 1) the occurrence of >25% increase in serum creatinine level <72 h after randomization; and 2) a reduction in reperfusion injury measured as myocardial salvage index by magnetic resonance imaging. RESULTS:The median volume of an iso-osmolar contrast agent during angiography was 180 ml (interquartile range [IQR] 140 to 230 ml) in the N-acetylcysteine and 160 ml (IQR 120 to 220 ml) in the placebo group (p = 0.20). The primary end point contrast-induced nephropathy occurred in 14% of the N-acetylcysteine group and in 20% of the placebo group (p = 0.28). The myocardial salvage index was also not different between both treatment groups (43.5; IQR 25.4 to 71.9 vs. 51.5; IQR 29.5 to 75.3; p = 0.36). Activated oxygen protein products and oxidized low-density lipoprotein as markers for oxidative stress were reduced by as much as 20% in the N-acetylcysteine group (p < 0.05), whereas no change was evident in the placebo group. CONCLUSIONS:High-dose intravenous N-acetylcysteine reduces oxidative stress. However, it does not provide an additional clinical benefit to placebo with respect to CIN and myocardial reperfusion injury in nonselected patients undergoing angioplasty with moderate doses of contrast medium and optimal hydration. (Myocardial Salvage and Contrast Dye Induced Nephropathy Reduction by N-Acetylcysteine [LIPSIA-N-ACC]; NCT00463749).
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Thiele H,Hildebrand L,Schirdewahn C,Eitel I,Adams V,Fuernau G,Erbs S,Linke A,Diederich KW,Nowak M,Desch S,Gutberlet M,Schuler Gdoi
10.1016/j.jacc.2009.08.091subject
Has Abstractpub_date
2010-05-18 00:00:00pages
2201-9issue
20eissn
0735-1097issn
1558-3597pii
S0735-1097(10)00950-2journal_volume
55pub_type
杂志文章,随机对照试验abstract::The prognostic significance of the type of first acute myocardial infarction (Q wave versus non-Q wave) and Q wave location (anterior versus inferoposterior) was determined from a multicenter data base involving 777 placebo-treated patients who were participants in the Multicenter Diltiazem Post-Infarction Trial. Ther...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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abstract:OBJECTIVE:The objective of this study is to evaluate the one-year outcome of the first 50 patients who underwent nonsurgical septal reduction for symptomatic hypertrophic obstructive cardiomyopathy at our institution. BACKGROUND:Left ventricular outflow tract obstruction is an important determinant of clinical symptom...
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abstract::Using contrast-enhanced computed tomography, the effects of hyperosmolar mannitol and methylprednisolone on experimentally produced myocardial infarcts were evaluated serially over the course of approximately 1 month. Infarct size, initial perfusion defect (jeopardized segment) and noninfarcted muscle mass were determ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,收录出版
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abstract:OBJECTIVES:This study was designed to investigate the appropriateness and complications of the use of spironolactone for heart failure (HF) in clinical practice. BACKGROUND:Spironolactone was reported by one prospective randomized trial to decrease morbidity and mortality in patients with New York Heart Association (N...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,评论,杂志文章,随机对照试验
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更新日期:2004-02-18 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2015-06-16 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2002-06-05 00:00:00
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0735-1097(03)01059-3
更新日期:2003-10-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2018-04-24 00:00:00
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更新日期:2012-12-25 00:00:00
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更新日期:2002-06-19 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2017-07-11 00:00:00
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更新日期:2005-06-21 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2007-01-23 00:00:00
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更新日期:2013-07-09 00:00:00
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2005-07-19 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1998-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00469-0
更新日期:1998-12-01 00:00:00
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更新日期:1998-05-01 00:00:00
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更新日期:1995-08-01 00:00:00