N-Acetylcysteine-Enhanced Contrast Provides Cardiorenal Protection

Markus Meyer, Martin M. LeWinter, Stephen P. Bell, Zengyi Chen, Donald E. Selby, Dinender K. Singla, Harold L. Dauerman

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)215-221
Number of pages7
JournalJACC: Cardiovascular Interventions
Volume2
Issue number3
DOIs
StatePublished - Mar 2009
Externally publishedYes

Bibliographical note

Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.

Keywords

  • antioxidants
  • contrast medium
  • ischemia
  • reperfusion

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