N-acetylcysteine diminishes injury induced by balloon angioplasty of the carotid artery in rabbits.

The effect of N-acetylcysteine (NAC) on preventing or ameliorating the injury associated with percutaneous transluminal angioplasty was investigated in rabbits. Carotid artery angioplasty (CA) was performed on 8 control (vehicle-treated) rabbits and 7 rabbits treated with NAC, 250 mg/kg, administered orally in Nutrical paste for 10 days prior to and 10 days following CA. Single blind histologic evaluation of the angioplasty sites demonstrated a significant reduction in the incidence in vessel: 1) inflammation; 2) endothelial damage; 3) thrombus formation; 4) elastic lamina damage in the NAC rabbits. The percentage of control versus NAC treated animals exhibiting damage in each category were: inflammation: 75% vs 14%; endothelial damage: 88% vs 57%; thrombus formation: 88% vs 43%; laminal damage: 63% vs 14%. The results suggest that NAC treatment may be a valuable therapeutic agent in effectively preventing or reducing angioplasty-induced vessel damage.

On the use of parenteral magnesium salts in the treatment of acute ischaemic heart disease: a brief review.

With the advent of pharmacological, mechanical and surgical revascularization as firstline therapies in acute coronary artery disease syndromes, the search for adjunctive pharmacotherapy against reocclusion and reperfusion injury has intensified. In addition, safe pharmacotherapeutic intervention conferring survival advantage is required for those at high risk ineligible for recanalization or beta blockade. Of major importance, in this vein, is the intriguing association between parenteral magnesium and the amelioration of myocardial ischaemia and the eradication of lethal ischaemic ventricular arrhythmias reasserted in both animal and human studies. In addition, in more recent years, parenteral magnesium has been linked to the amelioration of reperfusion injury in animal experiments. In this paper we shall review the literature with respect to myocardial ischaemia, its pathophysiology and treatments. In doing so, we shall present data that strongly supports the logistic use of parenteral magnesium compounds as essential therapy in the treatment of acute ischaemic heart disease associated with necrosis, and a potential role in ablating reperfusion injury.