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            -Acetylcysteine in Combination With Nitroglycerin and Streptokinase for the Treatment of Evolving Acute Myocardial Infarction

Arstall, Margaret A.; Yuan, Jinqing; Stafford, Irene; Betts, W H; Horowitz, John D.

doi:10.1161/01.cir.92.10.2855

Cited by 143 publications

(106 citation statements)

References 56 publications

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“…The antioxidant and vasodilatory effects of NAC may have directly influenced subsequent mortality in these patients with cardiac disease. More specifically, NAC administration in patients with AMI has been associated with diminished oxidative stress, more rapid coronary reperfusion, preservation in ventricular function, and a decrease in the size of infarct (14,15). Furthermore, the incidence of CIN was somewhat higher than expected given the relatively preserved renal function of the study population and a 15% prevalence of diabetes.…”

Section: Randomized Clinical Trialsmentioning

confidence: 85%

Contrast-Induced Nephropathy

Rudnick¹,

Feldman²

2008

Clinical Journal of the American Society of Nephrology

145

120

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Background and objectives:Observational studies have demonstrated that short-and long-term mortality is increased in patients who develop contrast-induced nephropathy (CIN). The more clinically relevant questions, and the objectives of this review, are whether CIN is causally related to mortality, and to what extent could mortality in patients undergoing contrast procedures be reduced by preventing CIN.Design, setting, participants, & measurements: A literature review was conducted, focusing on observational studies that assessed factors associated with mortality in patients with CIN.Results: The deaths of some patients with CIN are complicated by factors that cannot be directly related to CIN, such as liver disease, sepsis, respiratory failure, bleeding, etc. However, it is plausible that CIN contributes to cardiovascular causes of death in patients with CIN.Conclusions: At the very least, CIN is a marker for increased mortality. More carefully designed prospective studies are needed to fully elucidate the relationship between CIN and death. In the absence of data disproving a causal relationship between CIN and death in all subgroups, reducing its incidence should remain a goal in clinical practice as well as a target for future research.

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Section: Randomized Clinical Trialsmentioning

confidence: 85%

Contrast-Induced Nephropathy

Rudnick¹,

Feldman²

2008

Clinical Journal of the American Society of Nephrology

145

120

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“…However, it is also used for the diseases of the lungs, liver, heart, and kidney in order to treat their toxic and ischemic injuries [22][23][24][25] .…”

Section: Discussionmentioning

confidence: 99%

N-acetylcysteine Prevents Gentamicin Ototoxicity in a Rat Model

Somdas¹,

Korkmaz²,

Gürgen³

et al. 2015

Int Adv Otol

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OBJECTIVE:The possible preventive effect of N-acetylcysteine (NAC) in gentamicin ototoxicity was studied with auditory brain stem responses (ABRs), otoacoustic emissions (OAEs), and histopathological investigation of the cochlea. MATERIALS and METHODS:This study is conducted on 36 rats in three groups. Gentamicin, gentamicin plus NAC, and NAC alone were intraperitoneally administered for 15 days. The rats were sacrificed to study the cochleas after testing hearing levels. RESULTS:ABR thresholds and OAEs were attenuated in the gentamicin group, in which apoptosis was detected with histopathological investigation. The group that received NAC in addition to gentamicin had better ABR thresholds and better OAEs. The histopathological evidence of apoptosis in was considerably less in this group. CONCLUSION:Gentamicin ototoxicity can be detected by ABR and OAE testing in rats, and NAC may protect the cochlear cells from apoptosis.

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“…The mechanism of attenuation of renal injury with N-acetylcysteine is believed to be the scavenging of oxygen-derived free radicals in the renal tubule, which is similar to the mechanism of sodium bicarbonate. 25,26 Miner et al previously reported that N-acetylcysteine reduced contrast-induced nephropathy but not clinical events (death, myocardial infarction, dialysis, hospitalization) during 9 months of follow-up. 27 A discrepancy in longterm clinical outcomes between this previous study and the present study may partially be explained by the difference in study populations.…”

Section: Effect Of Other Preventive Therapy For Contrast-induced Nephmentioning

confidence: 99%

Sodium Bicarbonate Improves Long-Term Clinical Outcomes Compared With Sodium Chloride in Patients With Chronic Kidney Disease Undergoing an Emergent Coronary Procedure

Masuda

Yamada

Okuyama

et al. 2008

Circ J

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Study ProtocolEligible patients were randomly assigned to the sodium bicarbonate group or the sodium chloride group. Patients allocated to the 2 groups received 154 mmol/L of either sodium bicarbonate or sodium chloride. As soon as possible after admission, the following hydration protocol was started. The initial intravenous bolus was 3 ml·kg -1 ·h -1 for 1 h, if possible, before the coronary procedure. Patients subsequently received the same fluid at a rate of 1 ml·kg -1 ·h -1 J 2008; 72: 1610 -1614 (Received April 15, 2008 revised manuscript received May 26, 2008; accepted June 3, 2008; released online August 29, 2008 Background Contrast-induced nephropathy is associated with increased in-hospital and long-term adverse clinical outcomes. Circ Methods and ResultsTo investigate whether hydration with sodium bicarbonate improves long-term clinical outcomes compared with sodium chloride, patients with chronic kidney disease undergoing an emergent coronary procedure were enrolled in a randomized clinical trial with ≥1 year of follow-up. The 59 patients with chronic kidney disease (serum creatinine concentration >1.1 mg/dl or estimated glomerular filtration rate <60 ml/min) were randomly assigned to receive a 154 mmol/L intravenous infusion of either sodium bicarbonate (n=30) or sodium chloride (n=29). The electrolytes were given as a bolus of 3 ml·kg -1 ·h -1 for 1 h before the administration of contrast, followed by an infusion of 1 ml·kg -1 ·h -1 for 6 h during and after the procedure. During a mean follow-up period of 15.9±4.5 months, the incidence of renal replacement therapy or death was significantly lower in the sodium bicarbonate group than in the sodium chloride group (3% vs 21%, respectively; p=0.037).Conclusions Hydration with sodium bicarbonate reduces the incidence of renal replacement therapy and death in patients with chronic kidney disease undergoing an emergent coronary procedure. (Circ J 2008; 72: 1610 -1614

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N -Acetylcysteine in Combination With Nitroglycerin and Streptokinase for the Treatment of Evolving Acute Myocardial Infarction

Abstract: NAC in combination with NTG and streptokinase appeared to be safe for the treatment of evolving AMI and was associated with significantly less oxidative stress, a trend toward more rapid reperfusion, and better preservation of left ventricular function.

Cited by 143 publications

References 56 publications

Contrast-Induced Nephropathy

Contrast-Induced Nephropathy

N-acetylcysteine Prevents Gentamicin Ototoxicity in a Rat Model

Sodium Bicarbonate Improves Long-Term Clinical Outcomes Compared With Sodium Chloride in Patients With Chronic Kidney Disease Undergoing an Emergent Coronary Procedure

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