Meta-analysis/ International Journal of Cardiology 209 / 319
Dr. Prashant Kumar
Meta-analysis/ International Journal of Cardiology 209 / 319–327/ 2016

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The effect of N-acetylcysteine on the incidence of contrast-induced kidney injury: A systematic review and trial sequential analysis
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* There have been a myriad of studies investigating the effectiveness of N-acetylcysteine (NAC) in the prevention of contrast induced nephropathy (CIN) in patients undergoing coronary angiography (CAG) with or without percutaneous coronary intervention (PCI).

* The effectiveness of NAC on prevention of CIN is long time debate.


Contrast agents are thought to induce direct toxic damage to renal tubules, changes in renal hemo-dynamics and an increase in oxidative stress via generation of free radicals. NAC is hypothesized to benefit by its antioxidant effects and renal hemodynamic effects.

The risk of CIN increases in patients with known renal dysfunction and diabetes.


The present paper concludes that NAC is bene?cial in reducing rates of CIN amongst patients undergoing CAG. The results of the TSA suggest that no further RCTs are required to investigate the bene?t of NAC for a RRR of 15%. However future studies should examine the bene?ts of NAC in high-risk groups utilizing a standardized protocol to control for heterogeneity.

https://www.dropbox.com/s/41uytdei74o7zgp/The effect of N acetylcysteine on the incidence of contrast induced kidney injury A systematic review and trial sequential analysis.pdf?dl=0
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