Document Detail

The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial.
MedLine Citation:
PMID:  12600912     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with end-stage renal failure have increased oxidative stress and show elevated cardiovascular mortality. Whether increased cardiovascular events can be prevented by the administration of antioxidants is unknown. METHODS AND RESULTS: We evaluated the effects of acetylcysteine, a thiol-containing antioxidant, on cardiovascular events in patients undergoing hemodialysis. A prospective, randomized, placebo-controlled trial was conducted between October 1, 1999, and September 30, 2001, in 134 patients (76 male and 58 female) with a mean age of 62+/-16 years (mean+/-SD) who had been undergoing maintenance hemodialysis for a minimum of 3 months 3 times weekly in an ambulatory center. Median (range) follow-up was 14.5 (1 to 24) months. Patients were randomly assigned either to receive acetylcysteine (600 mg BID) or placebo. The primary end point was a composite variable consisting of cardiac events including fatal and nonfatal myocardial infarction, cardiovascular disease death, need for coronary angioplasty or coronary bypass surgery, ischemic stroke, peripheral vascular disease with amputation, or need for angioplasty. Secondary end points included each of the component outcomes, total mortality, and cardiovascular mortality. A total of 18 (28%) of the 64 hemodialysis patients assigned to acetylcysteine group and 33 (47%) of the 70 hemodialysis patients assigned to control group had a primary end point (relative risk, 0.60 [95% CI, 0.38 to 0.95], P=0.03). No significant differences in secondary end points or total mortality were detected. CONCLUSIONS: In hemodialysis patients, treatment with acetylcysteine (600 mg BID) reduces composite cardiovascular end points.
Martin Tepel; Markus van der Giet; Mario Statz; Joachim Jankowski; Walter Zidek
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation     Volume:  107     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-25     Completed Date:  2003-03-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  992-5     Citation Subset:  AIM; IM    
Med Klinik IV, Univ.-Klinik Benjamin Franklin, Freie Universität Berlin, Germany.
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MeSH Terms
Acetylcysteine / therapeutic use*
Antioxidants / therapeutic use*
Cardiovascular Diseases / mortality,  prevention & control*
Endpoint Determination
Kidney Failure, Chronic / diagnosis,  drug therapy*,  therapy
Middle Aged
Myocardial Infarction / mortality,  prevention & control
Renal Dialysis
Survival Analysis
Treatment Outcome
Reg. No./Substance:
0/Antioxidants; 616-91-1/Acetylcysteine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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