Evaluation of N-acetylcystein effects on cardiac remodeling biomarkers

Not Applicable

Conditions: Acute Myocardial Infarction.
Acute myocardial infarction

Registration Number: IRCT138905093449N2

Lead Sponsor: Tehran University of Medical sciences

Brief Summary: The aims of this study were to evaluate the effects of N-acetylcysteine (NAC) on the cardiac remodeling and major adverse events following AMI. In a prospective double-blind randomized clinical trial, the effect of NAC on the serum levels of cardiac biomarkers was compared with placebo in 88 patients with AMI. Also the patients were followed-up for one year period for major adverse cardiac events (MACE) including the occurrence of recurrent MI, death and need for target vessel re-vascularization. In patients who received NAC the serum levels of MMP-9 and MMP-2 after 72 hours were significantly lower than those in placebo group (p=0.014 and p=0.045, respectively). The length of hospitalization in patients who received NAC was significantly shorter than those in placebo group (p=0.024). With respect to MACE, there was a significant difference between those received NAC (14%) compared to patients on placebo (25%) (p=0.024). Re-infarction took place in 4% of patients in NAC group as compared to 16.7% in patients received placebo (p=0.007). NAC can be beneficial in preventing early remodeling by reducing the level of MMP-2 and MMP-9. Moreover, NAC decreased the length of hospital stays in patients after AMI. By decreasing MACE, NAC could possibly be introduced as a magic bullet in the pharmacotherapy of patients with AMI. Further studies are needed to elucidate NAC role in this population. Keywords: NAC, AMI, Remodeling, Matrix metalloproteinase

Detailed Description: Not available

Recruitment & Eligibility

Status: Complete

Sex: All

Target Recruitment: 100

Inclusion Criteria

ST-elevation AMI diagnosed by the following criteria: (1) typical chest pain lasting >30 minutes, (2) 1-mm ST elevation in 2 contiguous limb leads or 2-mm ST elevation in 2 contiguous chest leads, and (3) increase in creatine kinase or in troponin T level to 2 times the upper limit of normal. Exclusion criteria: previous AMI or HF, AF or valve disease, and history of neoplastic, renal, liver, or thyroid disease, acute or chronic infections or autoimmune diseases, under treatment with anti-inflammatory drugs, or underwent surgical procedures in the preceding 3 months, unwillingness for entering in the study

Exclusion Criteria

Not provided

Study & Design

Study Type: interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
MMP-9 as early cardiac remodeling biomarker. Timepoint: 24 and 72 hours after administration of NAC. Method of measurement: Elisa.;Nt-pro-BNP as early cardiac remodeling biomarker. Timepoint: 24 and 72 hours after administration of NAC. Method of measurement: Elisa.;MMP-2 as early cardiac remodeling biomarker. Timepoint: 24 and 72 hours after administration of NAC. Method of measurement: Elisa.

Secondary Outcome Measures