Myocardial Salvage and Contrast Dye Induced Nephropathy Reduction by N-Acetylcystein

Conditions

Myocardial Infarction

Keywords

primary PCI, nephropathy, infarct size, infarction, ST-elevation myocardial infarction

Brief summary

Acetylcystein is a potent antioxidans which is able to prevent contrast dye induced nephropathy in stable patients undergoing additional hydration. In primary percutaneous intervention for infarction hydration is not possible. Therefore Acetylcystein might prevent contrast dye induced nephropathy. Furthermore, it might reduce infarct size as a result of its antioxidant properties. Clinical trials are missing so far examining the effects of Acetylcystein on nephropathy and infarct size.

Suzanne de Waha, Ingo Eitel, Steffen Desch, Georg Fuernau, Philipp Lurz et al. (9 authors)

Trials2014-06-2555 citations

10.1186/1745-6215-15-249

Myocardium at risk in ST-segment elevation myocardial infarction comparison of T2-weighted edema imaging with the MR-assessed endocardial surface area and validation against angiographic scoring.

Fuernau G, Eitel I, Franke V, Hildebrandt L, Meissner J, de Waha S, Lurz P, Gutberlet M, Desch S, Schuler G, Thiele H.

2011-09-0140 citations

10.1016/j.jcmg.2011.02.023

Growth-differentiation factor 15 as predictor of mortality in acute reperfused ST-elevation myocardial infarction: insights from cardiovascular magnetic resonance.

Eitel I, Blase P, Adams V, Hildebrand L, Desch S, Schuler G, Thiele H.

2011-02-2255 citations

10.1136/hrt.2010.219543

Impact of high-dose N-acetylcysteine versus placebo on contrast-induced nephropathy and myocardial reperfusion injury in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. The LIPSIA-N-ACC (Prospective, Single-Blind, Placebo-Controlled, Randomized Leipzig Immediate PercutaneouS Coronary Intervention Acute Myocardial Infarction N-ACC) Trial.

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 G.

2010-05-01158 citations

10.1016/j.jacc.2009.08.091

Interventions

DRUGAcetylcystein

high-dose N-Acetylcystein during PCI and for 2/day for 2 days

DRUGPlacebo

NaCl as placebo

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

SINGLE (Subject)

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* ST-elevation infarction (\<12 hours) * Angina

Exclusion criteria

* Prior fibrinolysis * Dialysis * Pregnancy * Lactase-reduction * Glucose-galactose malabsorption * Known allergy to acetylcystein

Design outcomes

Primary

Measure	Time frame
Myocardial salvage measured by magnetic resonance imaging	4 days
prevention of nephropathy	3 days

Secondary

Measure	Time frame
composite clinical endpoint (death, reinfarction, congestive heart failure)	30 days
need for dialysis	4 days
ST-segment resolution	90 min
infarct size measured by magnetic resonance	4 days
oxidative stress	72 hours
microvascular obstruction measured by magnetic resonance	4 days
TIMI flow	minutes

Countries

Germany

Outcome results

None listed