Evaluating the effect of N-acetyl cysteine on the Early Remodeling Biomarkers (MMPs & NT-Pro-BNP) in patients following acute myocardial infarction

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