title: Does N-acetylcysteine reduce the incidence of contrast-induced nephropathy and clinical events in patients undergoing primary angioplasty for acute myocardial infarction?
abstract: OBJECTIVE
  We examined oral N-acetylcysteine effects on contrast-induced nephropathy (CIN) and clinical events in patients undergoing primary angioplasty for acute myocardial infarction.
  
  
  BACKGROUND
  Recent studies have reported that N-acetylcysteine reduces CIN and improves the clinical outcome in patients undergoing primary angioplasty. However, additional investigations are warranted to further support these findings.
  
  
  METHODS
  We randomly assigned 76 patients undergoing primary angioplasty into two groups: 38 patients were assigned to N-acetylcysteine (NAC, 705 mg orally administration before and 12, 24, 36 hours after primary angioplasty), and 38 patients to placebo. CIN was defined as an increase in the serum creatinine concentration of 25 percent or more from baseline value within the 72-hour period after primary angioplasty.
  
  
  RESULTS
  CIN occurred in 7 patients (9.2%). In the NAC group, the incidence of CIN tended to be lower than in the placebo group (NAC; 2/38; 5.3% vs. Placebo; 5/38; 13.2%, p=0.21). The composite endpoints such as death, acute renal failure requiring temporary renal replacement therapy, or need for mechanical ventilation did not occur in either group.
  
  
  CONCLUSIONS
  While N-acetylcysteine might have the possibility to reduce the incidence of contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction, the in-hospital mortality and morbidity were not significantly different between the two groups.
authors.affiliation: Department of Cardiology, Okazaki City Hospital, Japan. akihito17491194@gmail.com
authors.forename: Akihito
authors.initials: A
authors.lastname: Tanaka
authors.forename: Yoriyasu
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Hirai
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yasuda
authors.forename: Ken
authors.initials: K
authors.lastname: Miki
authors.forename: Masaya
authors.initials: M
authors.lastname: Fujita
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tanaka
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D000284:Administration, Oral; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D016166:Free Radical Scavengers; D003404:Creatinine; D000111:Acetylcysteine