title: A randomized controlled trial of N-acetylcysteine to prevent contrast nephropathy in cardiac angiography.
abstract: BACKGROUND
  Contrast nephropathy (CN) is a common cause of renal dysfunction after cardiac angiography. Recently, N-acetylcysteine (NAC) has been found to reduce the risk of CN after CT imaging with contrast enhancement. The purpose of the current study was to evaluate the efficacy of NAC for the prevention of CN in the setting of cardiac angiography.
  
  
  METHODS
  Eligible patients were those undergoing cardiac angiography with serum creatinine>1.7 mg/dL. Patients were randomized to one of two groups: Group 1, IV hydration and NAC, 1200 mg one hour before angiography, and a second dose 3 hours after; Group 2, IV hydration and placebo. CN was defined as an increase of 0.5 mg/dL in serum creatinine.
  
  
  RESULTS
  Seventy-nine patients completed the study. There were no significant differences between the groups in baseline characteristics, duration of angiography, mean volume of dye infused or mean IV hydration. Contrast nephropathy developed in 24.0% of subjects, 26.3% NAC, and 22.0% placebo (P = NS). Among subjects with diabetes mellitus, there was no significant difference in the rate of CN between the groups (42.1% NAC, 27.8% placebo; P = 0.09). The independent predictors of CN risk were diabetes mellitus and preexisting chronic renal insufficiency.
  
  
  CONCLUSIONS
  NAC was not effective for the prevention of CN after cardiac angiography.
authors.affiliation: Division of Nephrology, Department of Pharmacy, and Division of Cardiology, Winthrop-University Hospital, Mineola, New York, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Durham
authors.forename: Christopher
authors.initials: C
authors.lastname: Caputo
authors.forename: John
authors.initials: J
authors.lastname: Dokko
authors.forename: Thomas
authors.initials: T
authors.lastname: Zaharakis
authors.forename: Mohsen
authors.initials: M
authors.lastname: Pahlavan
authors.forename: Jan
authors.initials: J
authors.lastname: Keltz
authors.forename: Paula
authors.initials: P
authors.lastname: Dutka
authors.forename: Kevin
authors.initials: K
authors.lastname: Marzo
authors.forename: John K
authors.initials: JK
authors.lastname: Maesaka
authors.forename: Steven
authors.initials: S
authors.lastname: Fishbane
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology*; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D016166:Free Radical Scavengers / Q000494:pharmacology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D016166:Free Radical Scavengers; D000111:Acetylcysteine