Effects of N-Acetylcysteine on the Cardiac Remodeling Biomarkers and Major Adverse Events Following Acute Myocardial Infarction: A Randomized Clinical Trial

Abstract

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.

Oxidative Stress in Cell Death and Cardiovascular Diseases

“…Moreover, NAC can also inhibit maladaptive autophagy, which promotes the pathogenesis, in pressure overload-induced cardiac remodeling in rats [101]. The role of NAC has also been validated in the myocardial infarction patients, although these results need to be further explored in a larger population [102]. Vitamin E is another antioxidant with the clinical potential to the treatment of cardiovascular diseases.…”

The Clinical Efficacy of N-Acetylcysteine in the Treatment of ST Segment Elevation Myocardial Infarction

“…33) Talasaz, et al also found that NAC may help reduce levels of MMP-2 and MMP-9. 13) A total of 9 RCTs were included in this metaanalysis and all subjects had STEMI. After the analysis, it was found that all-cause mortality and MACE occurrence in the NAC group were significantly lower than in the placebo group.…”

“…Randomization was mentioned in all studies. However, 8 studies [8][9][10][11][12][13]15,16) expounded the generation of random sequences. Only one study 8) described allocation concealment.…”

“…Only one study 8) described allocation concealment. All studies [8][9][10][11][12][13][14][15][16] described the blinding of patients and personnel and selective reporting. Outcome assessments may be used to improve the therapeutic effectiveness.…”

New Drug Avenues for Cardioprotection in Patients with Acute Myocardial Infarction

“…In this issue of the Journal, Talasaz et al [25] once again address the efficacy of NAC to control post-MI remodeling. They suggest that NAC could improve the myocardial remodeling following AMI in a proof-ofconcept clinical trial.…”