| Effect of N-acetylcysteine on cystatin C-based renal function after elective coronary angiography (ENABLE Study): a prospective, randomized trial. | |
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MedLine Citation:
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PMID: 18793808 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Several studies have reported the role of N-acetylcysteine on the prevention of contrast induced nephropathy (CIN) with conflicting results. To date, the effect of acetylcysteine on cystatin C-based CIN has not been described. This study was designed to examine the incidence of cystatin C-based CIN and investigate the effect of N-acetylcysteine on the prevention of CIN after coronary angiography (CAG). METHODS: We conducted a prospective, randomized trial on 166 patients (80 patients in N-acetylcysteine group and 86 patients in control group) that underwent elective CAG with apparently normal renal function. Serum cystatin C and creatinine concentrations were measured before, and at 24 and 48 h after CAG. RESULTS: The overall incidence of cystatin C-based CIN among all study subjects was 10.2% (5.0% in N-acetylcysteine group and 15.1% in control group, p<0.05) and that of serum creatinine-based CIN was 6% (3.8% in N-acetylcysteine group and 8.1% in control group, p=NS). Kappa analysis between cystatin C-based CIN and serum creatinine-based CIN showed a substantial agreement (k=0.64). Multivariate logistic regression analysis showed that N-acetylcysteine administration was independently protective against the development of cystatin C-based CIN (Odd ratio[95% confidence interval] 0.255[0.066 to 0.994]) but there was a trend toward protection against that of serum creatinine-based CIN. CONCLUSIONS: This study suggests that in patients with apparently normal renal function, prophylactic oral N-acetylcysteine administration is effective at preventing cystatin C-based CIN development after elective coronary angiography and/or intervention, and that serum cystatin C might be a more sensitive marker of the early CIN than serum creatinine. |
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Authors:
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Byung Jin Kim; Ki Chul Sung; Bum Soo Kim; Jin Ho Kang; Kyu Beck Lee; Hyang Kim; Man Ho Lee |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2008-09-14 |
Journal Detail:
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Title: International journal of cardiology Volume: 138 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-01 Completed Date: 2010-04-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 239-45 Citation Subset: IM |
Copyright Information:
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Copyright 2008 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-Dong, Jongro-Gu, Seoul, 110-746 Republic of Korea. bjjake.kim@samsung.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetylcysteine
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administration & dosage* Administration, Oral Aged Biological Markers / blood Contrast Media / adverse effects* Coronary Angiography / adverse effects*, statistics & numerical data Creatinine / blood Cystatin C / blood* Female Free Radical Scavengers / administration & dosage Humans Incidence Kidney Diseases / chemically induced*, epidemiology, prevention & control* Kidney Function Tests Male Middle Aged Multivariate Analysis Prospective Studies Regression Analysis |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Contrast Media; 0/Cystatin C; 0/Free Radical Scavengers; 60-27-5/Creatinine; 616-91-1/Acetylcysteine |
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