Addition of N‐Acetyl Cysteine to Carvedilol Decreases the Incidence of Acute Renal Injury After Cardiac Surgery. Issue 2 (25th November 2013)

• Record Type: Journal Article
• Authors: Ozaydin, Mehmet; Peker, Tulay; Akcay, Selahaddin; Uysal, Bayram A.; Yucel, Habil; Icli, Atilla; Erdogan, Dogan; Varol, Ercan; Dogan, Abdullah; Okutan, Huseyin
• Is Part Of: Clinical cardiology. Volume 37:Issue 2(2014:Feb.)
• Page Start: 108
• Page End: 114
• Publication Date: 2013-11-25
• Subjects: Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22227
• Languages: English
• ISSNs: 0160-9289

Abstract

<abstract abstract-type="main" id="clc22227-abs-0001"> <title>ABSTRACT</title> <sec id="clc22227-sec-0001" sec-type="section"> <title>Background</title> <p id="clc22227-para-0001">Oxidative stress and inflammation during cardiac surgery may be associated with acute renal injury (ARI). N‐acetyl cysteine (NAC) and carvedilol have antioxidant and anti‐inflammatory properties.</p> </sec> <sec id="clc22227-sec-0002" sec-type="section"> <title>Hypothesis</title> <p id="clc22227-para-0002">A combination of carvedilol and NAC should decrease the incidence of ARI more than metoprolol or carvedilol.</p> </sec> <sec id="clc22227-sec-0003" sec-type="section"> <title>Methods</title> <p id="clc22227-para-0003">Patients undergoing cardiac surgery were randomized to metoprolol, carvedilol, or carvedilol plus NAC. End points were occurrence of ARI and change in preoperative to postoperative peak creatinine levels.</p> </sec> <sec id="clc22227-sec-0004" sec-type="section"> <title>Results</title> <p id="clc22227-para-0004">ARI incidence was lower in the carvedilol plus NAC group compared with the metoprolol (21.0% vs 42.1%; <italic>P</italic> = 0.002) or carvedilol (21.0% vs 38.6%; <italic>P</italic> = 0.006) groups, but was similar between the metoprolol and carvedilol groups (<italic>P</italic> = 0.62). Preoperative and postoperative day 1 creatinine levels were similar among the metoprolol (1.02 [0.9–1.2] and 1.2 [0.92–1.45]) the carvedilol (1.0 [0.88–1.08] and 1.2 [0.9–1.5]) and the carvedilol plus NAC groups (1.06 [0.9–1.18] and 1.1 [1.0–1.21] mg/dL; all <italic>P</italic> values >0.05). Postoperative day 3, day 5, and peak creatinine levels were lower in the carvedilol plus NAC group (1.11 [1.0–1.23], 1.14 [1.0–1.25] and 1.15 [1.0–1.25]) as compared with the metoprolol (1.4 [1.3–1.49], 1.3 [1.0–1.54] and 1.3 [1.0–1.54]) or carvedilol groups (1.2 [1.0–1.52], 1.25 [1.0–1.52] and 1.25 [1.0–1.55] mg/dL; all <italic>P</italic> values <0.05), but were similar between the metoprolol and carvedilol groups (all <italic>P</italic> values >0.05).</p> </sec> <sec id="clc22227-sec-0005" sec-type="section"> <title>Conclusions</title> <p id="clc22227-para-0005">Combined carvedilol and NAC decreased ARI incidence as compared with carvedilol or metoprolol. No difference was detected between carvedilol and metoprolol.</p> </sec> </abstract>