N-Acetylcysteine for the prevention of postoperative atrial fibrillation: a randomized, placebo-controlled pilot study.

March 05, 2008

Oxidative stress has recently been implicated as a cause of atrial fibrillation (AF). The aim of the present study was to evaluate the effects of N-Acetylcysteine (NAC) on postoperative AF. The population of this prospective, randomized, double-blind, placebo-controlled study consisted of 115 patients undergoing coronary artery bypass and/or valve surgery. All the patients were treated with standard medical therapy and were randomized to receive either NAC group (58 patients) or placebo (57 patients). An AF episode of greater than 5 minutes during hospitalization was accepted as the overall outcome. During the follow-up period, 15 patients (15 out of 115 or 13%) had AF. The rate of AF was lower in NAC group compared with placebo group (three patients in NAC group [5.2%] and 12 patients in placebo group [21.1%] had postoperative AF. In the final analysis (multivariable logistic regression analysis) using N-Acetylcysteine decreased the risk of suffering an atrial fibrillation after open heart surgery by 80%. The authors conclude that the result of this study indicates that NAC treatment decreases the incidence of postoperative AF. The study is published in the February 8th, 2008 issue of the European Heart Journal

Alpha-Lipoic acid as a new treatment option for Alzheimer's disease--a 48 months follow-up analysis.

Researchers at the Department of Medical Rehabilitation and Geriatrics, Henriettenstiftung, Hanover, Germany tested the effects of Alpha-Lipoic-Acid (ALA) in Alzheimer’s diseased (AD) patients. Oxidative stress and depleted energy in brain cells are characteristic biochemical hallmarks of AD. It is therefore conceivable that the energy producing and antioxidant drug ALA might delay the onset or slow down the progression of the disease. In a previous study, 600mg ALA was given daily to nine patients with AD (receiving a standard treatment with choline-esterase inhibitors) in an open-label study over an observation period of 12 months. The treatment led to a stabilization of cognitive functions in the study group, demonstrated by constant scores in two neuropsychological tests (the mini mental state exam, MMSE and the Alzheimer's disease assessment score cognitive subscale, ADAScog).
In this new report, we have extended the analysis to 43 patients over an observation period of up to 48 months. In patients with mild AD dementia, the disease progressed extremely slowly when supplementing with ALA, in patients with moderate dementia at approximately twice the rate. However, the progression appears dramatically lower than data reported for untreated patients or patients on choline-esterase inhibitors in the second year of long-term studies. Our data suggests that treatment with ALA might be a successful 'neuroprotective' therapy option for AD. The study appears in the Journal of Neurotransmission, Supplement; 2007(72).