Document Detail

N-acetylcysteine-enhanced contrast provides cardiorenal protection.
MedLine Citation:
PMID:  19463428     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to evaluate the cardiac and renal effects of an N-acetylcysteine (NAC)-enhanced intracoronary radiographic contrast agent.
BACKGROUND: Recent studies suggest that high-dose NAC provides better protection from contrast-induced nephropathy, and the antioxidant properties of NAC may also provide cardiac protection. The use of angiographic contrast agents as a drug delivery vehicle for cardiorenal protection effects has not been investigated.
METHODS: In a pig model of prolonged cardiac ischemia-reperfusion, NAC-enhanced contrast medium was tested and compared with iopamidol contrast only. Myocardium and renal function were assessed after 24 h.
RESULTS: There was no significant difference in the area-at-risk for myocardial infarction (MI) between contrast only and NAC-enhanced contrast medium. In contrast, MI size was about 40% smaller in NAC-enhanced contrast medium-treated animals. These findings were associated with a significant difference in MI morphology. MIs in the NAC-enhanced contrast medium group had a mottled appearance, whereas in the contrast only group they were homogeneous and had a discrete border zone. These differences could explain a higher incidence of periprocedural ventricular arrhythmias in the NAC-enhanced contrast medium group. Histopathological analysis of the myocardium revealed a reduction in programmed cell death by NAC-enhanced contrast medium that may explain the increase in ischemia tolerance. Last, NAC-enhanced contrast medium administration blunted the rise in serum creatinine levels by about 60% and protected from renotubular apotosis.
CONCLUSIONS: NAC-enhanced contrast medium reduces MI size and protects renal function in a pig model of ischemia and reperfusion.
Markus Meyer; Martin M LeWinter; Stephen P Bell; Zengyi Chen; Donald E Selby; Dinender K Singla; Harold L Dauerman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  2     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2010-09-29     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  215-21     Citation Subset:  IM    
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MeSH Terms
Acetylcysteine / adverse effects,  pharmacology*
Angioplasty, Balloon, Coronary*
Contrast Media / adverse effects,  pharmacology*
Creatinine / blood
Disease Models, Animal
Feasibility Studies
Free Radical Scavengers / adverse effects,  pharmacology*
Iopamidol / adverse effects,  pharmacology*
Kidney / drug effects
Kidney Diseases / chemically induced*,  prevention & control
Myocardial Infarction*
Risk Factors
Grant Support
T32 HL007647-20/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Contrast Media; 0/Free Radical Scavengers; AYI8EX34EU/Creatinine; JR13W81H44/Iopamidol; WYQ7N0BPYC/Acetylcysteine
Comment In:
JACC Cardiovasc Interv. 2009 Mar;2(3):222-3   [PMID:  19463429 ]

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