Acetylcysteine protects from radiocontrast-induced nephropathy after Prim.Angioplasty

[Dr.Vad]

Дозозависимый протективный эффект ацетилцистеина от радиоконтраст-индуцированной нефропатии после первичной ангиопластики:

RCIN occurred in 66/352 patients (19%) overall: 17/115 (15%) who received standard-dose (3,000 mg) acetylcysteine; 10/118 (8%) who received high-dose (6,000 mg) acetylcysteine; and 39/119 (33%) who were given placebo (P < 0.001). Multivariate logistic regression, with adjustment for factors including age, baseline serum creatinine level and contrast volume, revealed that placebo was associated with a significantly higher risk of RCIN than standard-dose acetylcysteine (odds ratio 2.60; 95% CI 1.30-5.18; P = 0.007) or high-dose acetylcysteine (odds ratio 5.78; 95% CI 2.56-13.16; P < 0.001). In-hospital mortality rate was significantly higher among patients on placebo (11%) than among patients who received standard-dose acetylcysteine (4%) or high-dose acetylcysteine (3%; P = 0.02). Patients on placebo also showed a significantly higher incidence of a composite endpoint comprising death, acute renal failure, or need for mechanical ventilation (18%) than those in the standard-dose or high-dose acetylcysteine groups (7% and 5%, respectively; P = 0.002).

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