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).