PMID- 21542122
OWN - NLM
STAT- MEDLINE
DCOM- 20120813
LR  - 20161125
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 79
IP  - 6
DP  - 2012 May 1
TI  - A randomized trial of intravenous n-acetylcysteine to prevent contrast induced 
      nephropathy in acute coronary syndromes.
PG  - 921-6
LID - 10.1002/ccd.23157 [doi]
AB  - BACKGROUND: Pharmacokinetic data suggests that the intravenous form of 
      n-acetylcysteine (NAC) may be more effective than the oral formulation in 
      preventing contrast induced nephropathy (CIN). NAC owing to its anti-oxidant 
      properties might be beneficial for patients with acute coronary syndromes (ACS) 
      who are at increased risk for CIN. The aim of this prospective randomized, 
      single-center, double-blind, placebo controlled trial (NCT00939913) was to assess 
      the effect of high-dose intravenous NAC on CIN in ACS patients undergoing 
      coronary angiography and/or percutaneous coronary intervention (PCI). METHODS: We 
      randomized 398 ACS patients scheduled for diagnostic angiography +/- PCI to an 
      intravenous regimen of high-dose NAC (1,200 mg bolus followed by 200 mg/hr for 24 
      hr; n = 206) or placebo (n = 192). The primary end-point was incidence of CIN 
      defined as an increase in serum creatinine concentration >/= 25% above the baseline 
      level within 72 hr of the administration of intravenous contrast. RESULTS: There 
      was no difference found for the primary end point with CIN in 16% of the NAC 
      group and in 13% of the placebo group (p = 0.40). Change in serum cystatin-C, a 
      sensitive marker for renal function, was 0.046 +/- 0.204 in the NAC group and 0.002 
      +/- 0.260 in the control group (p = 0.07). CONCLUSION: In ACS patients undergoing 
      angiography +/- PCI, high-dose intravenous NAC failed to reduce the incidence of 
      CIN.
CI  - Copyright (c) 2011 Wiley Periodicals, Inc.
FAU - Jaffery, Zehra
AU  - Jaffery Z
AD  - Department of Cardiovascular Diseases, The John Ochsner Heart & Vascular 
      Institute, Ochsner Clinic Foundation, New Orleans, Louisiana, USA. 
      zjaffery@ochsner.org
FAU - Verma, Anil
AU  - Verma A
FAU - White, Christopher J
AU  - White CJ
FAU - Grant, Arthur G
AU  - Grant AG
FAU - Collins, Tyrone J
AU  - Collins TJ
FAU - Grise, Mark A
AU  - Grise MA
FAU - Jenkins, James S
AU  - Jenkins JS
FAU - McMullan, Paul W
AU  - McMullan PW
FAU - Patel, Rajan A
AU  - Patel RA
FAU - Reilly, John P
AU  - Reilly JP
FAU - Thornton, Stanley N
AU  - Thornton SN
FAU - Ramee, Stephen R
AU  - Ramee SR
LA  - eng
SI  - ClinicalTrials.gov/NCT00939913
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20111130
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
RN  - 0 (Antioxidants)
RN  - 0 (Biomarkers)
RN  - 0 (CST3 protein, human)
RN  - 0 (Contrast Media)
RN  - 0 (Cystatin C)
RN  - 0 (Placebos)
RN  - AYI8EX34EU (Creatinine)
RN  - WYQ7N0BPYC (Acetylcysteine)
SB  - IM
CIN - Catheter Cardiovasc Interv. 2012 May 1;79(6):927-8. PMID: 22511379
MH  - Acetylcysteine/*administration & dosage
MH  - Acute Coronary Syndrome/*diagnostic imaging/therapy
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Antioxidants/*administration & dosage
MH  - Biomarkers/blood
MH  - Chi-Square Distribution
MH  - Contrast Media/*adverse effects
MH  - Coronary Angiography/*adverse effects
MH  - Creatinine/blood
MH  - Cystatin C/blood
MH  - Double-Blind Method
MH  - Female
MH  - Humans
MH  - Infusions, Intravenous
MH  - Kidney Diseases/blood/chemically induced/diagnosis/*prevention & control
MH  - Male
MH  - Middle Aged
MH  - New Orleans
MH  - Placebos
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2011/05/05 06:00
MHDA- 2012/08/14 06:00
CRDT- 2011/05/05 06:00
PHST- 2011/03/17 00:00 [received]
PHST- 2011/03/19 00:00 [accepted]
PHST- 2011/05/05 06:00 [entrez]
PHST- 2011/05/05 06:00 [pubmed]
PHST- 2012/08/14 06:00 [medline]
AID - 10.1002/ccd.23157 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2012 May 1;79(6):921-6. doi: 10.1002/ccd.23157. Epub 
      2011 Nov 30.