CHICAGO—N-acetylcysteine (NAC) may be superior to ascorbic acid in preventing contrast-induced nephropathy (CIN) in patients with renal insufficiency, Korean researchers reported here at the American Heart Association annual scientific sessions.
They enrolled 212 coronary catheterization patients with a creatinine clearance less than 60 mL/min or serum creatinine level 1.1 mg/dL or higher. They were randomized to receive oral NAC 1200 mg twice daily before and on the day of the procedure, or two doses of oral ascorbic acid (AA) before coronary catheterization (a 3 g dose and a 2 g dose) and 2 g twice after the procedure at a 12-hour interval. Half-isotonic saline was infused for 12 hours before and 12 hours after administration of iodixanol.

The groups had similar characteristics at baseline and received similar contrast medium doses. The investigators defined CIN as an increase of serum creatinine from baseline of 25% or more or a 0.5 mg/dL or greater increase. CIN occurred less frequently in the NAC group than the AA recipients (1.2% vs. 4.4%).

 The difference was not statistically significant, but NAC was associated with a lower increment in serum creatinine than ascorbic acid.

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