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Acetylcysteine Can Reduce Cardiovascular Events in Patients with Endstage Renal Disease: Presented at AHA-HBPR

By Peggy Peck
Special to DG News

ORLANDO, FL -- October 1, 2002 -- Antioxidant therapy with acetylcysteine appears to significantly reduce cardiovascular events among haemodialysis patients.

The research was presented here Sept. 30 at the American Heart Association's 56^th Annual Fall Conference and Scientific Sessions of the Council on High Blood Pressure Research.

Markus van der Giet, MD of Freie Universität Berlin and co-investigators from Universitätsklinikum Benjamin Franklin, Berlin, Germany, noted that patients with endstage renal failure have increased oxidative stress and show elevated cardiovascular mortality. The investigators sought to determine if increased oxidative stress could be the cause of cardiovascular events in this population and if administration of a potent antioxidant could reduce cardiovascular events.

They recruited 134 haemodialysis patients from October 1, 1999 through September 30, 2001. Seventy-six patients were men and the mean age of the patients was 62. All patients had been undergoing maintenance haemodialysis for a minimum of 3 months three times weekly in an ambulatory center.

The researchers randomly assigned 64 patients to receive acetylcysteine 600 mg bid and 70 patients to placebo. Patients were followed up for a mean of 13.7 months.

Primary outcome was a composite variable consisting of: cardiac events including fatal and non-fatal myocardial infarction, need for coronary angioplasty or coronary bypass surgery, ischemic stroke, peripheral vascular disease with amputation or need for angioplasty. Secondary outcomes included each of the component outcomes, total mortality, and cardiovascular mortality.

Eighteen (28 percent) of the 64 haemodialysis patients assigned to acetylcysteine group and 33 (47 percent) of the 70 haemodialysis patients assigned to control group had a primary endpoint (relative risk 0.60 (95 percent CI 0.38-0.95), p=0.03).

No significant differences in secondary endpoints, or total mortality were detected.

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