TABLE 7.
RCT comparing N acetyl cysteine as prevention method of CI-AKI.
| Name of study | Type of study | Type of population | Inclusion criteria (renal functions) | Number of patients | Type of intervention | CI-AKI incidence (study/control) |
| PRESERVE Trial (78) | RCT, multicentric | Indication for coronary or non-coronary angiography | eGFR 15–44 ml/min/1.73m2 or 45-59.9 ml/min/m2 with DM | 4,993 | FLUID (Saline or NaHCO3) + NAC, Total dose of 12,000 mg, oral. | 4.6% (114/2495)/4.5%(112/2498) |
| ACT Trial (211) | RCT, multicentric | Coronary or peripheral arterial diagnostic angiography or PCI | eGFR ≤ 60 ml/min/m2 | 1,369 | FLUID + NAC, total dose 4,800 mg, intravenous |
13.8% (97/702)/14.7% (98/667) |
| LIPSIA-N-ACC Trial (212) |
RCT, monocentric | STEMI patients undergoing primary PCI | Not mentioned-unrestricted | 251 | FLUID + NAC, total dose 6,000 mg, intravenous | 14% (18/126)/20% (25/125) |
| CASIS Trial (213) |
RCT, multicentric | Indication for coronary angiography or/and PCI | eGFR ≤ 60 ml/min/m2 | 220 |
Fluid or high dose fluid + NAC total dose 2.400 mg), intravenous | 2.5% (2/80)/16.3% (13/80)/ 10% (6/60) |
| Thayssen et al. (214) | RCT, multicentric | STEMI patients undergoing primary PCI | Not mentioned-unrestricted | 720 | Fluid with NAC or NAHCO3 or COMBINED | 20.1% (32/176)/20.1% (33/181)/20.1% 33/177 (20.8%)/26.5% (43/181) |
| Carbonell et al. (215) | RCT, monocentric | Indication for coronary angiography or/and PCI | eGFR > 60 ml/min/m2 | 216 | Fluid + NAC, Total dose of 2.400 mg, intravenous | 10.2% (11/107)/10,1% (11/109) |
| Kay et al. (216) | RCT, Monocentric | Indication for coronary angiography or/and PCI | eGFR > 60 ml/min/m2 | 200 | FLUID + NAC, Total dose of 2,400 mg | 4% (4/102)/12% (12/98) |
|
Jaffery et al. (217) |
RCT, Monocentric | ACS undergoing coronary angiography and/or PCI | Not mentioned-unrestricted | 398 | FLUID + NAC, total dose of 6,000 mg, intravenous | 16% (33/206)/13% (25/19) |
| Marenzi et al. (218) | RCT, Monocentric | STEMI patients undergoing primary PCI | Not mentioned-unrestricted | 354 | Fluid + NAC or HIGH DOSE NAC, Total dose of 3,000–6,000 mg, intravenous | 8% (10/118)/15% (17/115)/33% (39/119) |
| Reinecke et al. (132) | RCT, Monocentric | Elective left heart catheterization | sCr ≥ 1.3 mg/dl and ≤ 3.5 mg/dl | 412 | Fluid + NAC, total dose of 2,400 mg | 2.9% (4/140)/5.8% (8/137) (Omitting hemodialysis int. arm) |
eGFR, estimated glomerular filtration rate; NAC, N acetylcysteine; RCT, randomized clinical trial; Control, iv hydration alone with saline; sCr, serum creatinine.