Intrarenal application of N-acetylcysteine for the prevention of contrast medium-induced nephropathy in primary angioplasty

Coronary Artery Disease
Emre AslangerHuseyin Oflaz

Abstract

Contrast medium-induced nephropathy (CIN) is a well-known complication of coronary angiographic procedures, especially in patients treated with primary angioplasty. To prevent CIN, we examined using a local application of N-acetylcysteine (NAC) for the prevention of CIN during primary angioplasty. We hypothesized that a local application of NAC into the renal arteries would provide the benefit of a higher local concentration, lower first-pass metabolism, and faster efficacy. To evaluate the effects of NAC by the intrarenal route, we performed a prospective, randomized clinical study in patients with acute myocardial infarction treated with primary angioplasty. Participants were 312 patients with ST-segment elevation myocardial infarction undergoing primary angiography. Eligible patients were randomly assigned to receive intravenous NAC, intrarenal NAC, or placebo. Overall, CIN occurred in 74 (23.7%) of the 312 patients. The rate of CIN was 25% in the intravenous NAC group, 22.9% in the intrarenal NAC group, and 23.2% in the placebo group, with no significant effect seen for either treatment (P=0.64). We did find a significant correlation between CIN and ejection fraction (P=0.05) and baseline renal function (P=0.01). Both intra...Continue Reading

Citations

Dec 18, 2012·Journal of Interventional Cardiology·Sarah Victoria Ekeløf BuschIsmail Gögenur
Nov 28, 2015·Nutrition & Metabolism·Simona GranataGianluigi Zaza
Aug 20, 2016·Cardiovascular Drugs and Therapy·George ChalikiasDimitrios N Tziakas
Nov 12, 2019·Japanese Journal of Radiology·Yoshitaka IsakaUNKNOWN Japanese Society of Nephrology, Japan Radiological Society, and Japanese Circulation Society Joint Working Group
Nov 12, 2019·Clinical and Experimental Nephrology·Yoshitaka IsakaUNKNOWN Japanese Society of Nephrology, Japan Radiological Society, and Japanese Circulation Society Joint Working Group
Feb 9, 2021·Néphrologie & thérapeutique·Louis de LaforcadeUNKNOWN Commission Néphrologie Clinique de la Société Francophone de Néphrologie, Dialyse et Transplantation
Nov 12, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshitaka IsakaUNKNOWN Japanese Circulation Society Joint Working Group

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