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IRCT138905093449N2 IRCT 2010-09-04 Tehran University of Medical sciences Evaluation of N-acetylcystein effects on cardiac remodeling biomarkers Evaluating the effect of N-acetyl cysteine on the Early Remodeling Biomarkers (MMPs & NT-Pro-BNP) in patients following acute myocardial infarction 2010-08-23 anticipated 100 Complete https://irct.ir/trial/3535 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Used, Assignment: Parallel, Purpose: Prevention. N/A Acute Myocardial Infarction. Intervention 1: Intervention: NAC 600 mg BD PO for 3 days. Intervention 2: Control: Placebo BD PO for 3 days. The aims of this study were to evaluate the effects of N-acetylcysteine (NAC) on the cardiac remodeling and major adverse events following AMI.<br /> 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.<br /> 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).<br /> 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. <br /> Keywords: NAC, AMI, Remodeling, Matrix metalloproteinase<br />
public
scientific Hossein Khalili
Tehran University of Medical Sciences, Enghelab Ave,
Tehran Iran (Islamic Republic of) 1417614411 +98 21 6695 4715 khalilih@tums.ac.ir Tehran university of Medical Sciences Iran (Islamic Republic of) 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 no limit no limit Both I21 Acute myocardial infarction Prevention Prevention Intervention: NAC 600 mg BD PO for 3 days Control: Placebo BD PO for 3 days 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. Tehran University of Medical sciences Approved 2010-07-19 Tehran University of Medical Sciences Tehran University of Medical Sciences Tehran Iran (Islamic Republic of)