Effects of N-acetylcysteine on the cardiac remodeling biomarkers and major
adverse events following acute myocardial infarction: a randomized clinical
trial.
Author(s): Talasaz AH(1), Khalili H, Fahimi F, Jenab Y, Broumand MA, Salarifar M, Darabi F.
Affiliation(s): Author information:
(1)Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of
Medical Sciences, P.O.Box 14155/6451, 1417614411, Tehran, Iran.
Publication date & source: 2014, Am J Cardiovasc Drugs. , 14(1):51-61
AIMS: The aims of this study were to evaluate the effects of N-acetylcysteine
(NAC) on cardiac remodeling and major adverse events following acute myocardial
infarction (AMI).
METHODS: In a prospective, double-blind, randomized clinical trial, the effect of
NAC on the serum levels of cardiac biomarkers was compared with that of placebo
in 98 patients with AMI. Also, the patients were followed up for a 1-year period
for major adverse cardiac events (MACE), including the occurrence of recurrent
myocardial infarction, death, and need for target vessel revascularization.
RESULTS: In patients who received NAC, the serum levels of matrix
metalloproteinase (MMP)-9 and MMP-2 after 72 h were significantly lower than
those in the placebo group (p = 0.014 and p = 0.045, respectively). The length of
hospitalization in patients who received NAC was significantly shorter than that
in the placebo group (p = 0.024). With respect to MACE, there was a significant
difference between those who received NAC (14 %) and those patients on placebo
(25 %) (p = 0.024). Re-infarction took place in 4 % of patients in the NAC group
as compared with 16.7 % in patients who received placebo (p = 0.007).
CONCLUSION: 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's role in this population.
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