Fluimucil Reduces Kidney Failure in Primary Angioplasty

MILAN, June 28 ? The potent antioxidant Fluimucil (N-acetylcysteine) may prevent contrast-medium-induced nephropathy and preserve kidney function in patients who undergo primary angioplasty after a heart attack.

Moreover, the benefit of Fluimucil appears to be dose dependent, with the rate of death, acute renal failure requiring temporary dialysis or mechanical ventilation only 5% in patients randomized to high-dose Fluimucil, versus 7% in those who received a standard dose and 18% in controls (P=0.002), according to a report in the June 29 issue of New England Journal of Medicine.

Giancarlo Marenzi, M.D., and colleagues of the Institute of Cardiology at the University of Milan, randomized 116 patients to Fluimucil standard dose (600-mg intravenous bolus before primary angioplasty and 600 mg orally bid for 48 hours after angioplasty), 119 patients to double dose (1,200 mg bolus and 1,200 mg bid for 48 hours) and 119 to placebo.

Contrast-medium-induced nephropathy occurred in 66 patients and was more common among patients with reduced renal function at baseline (creatinine clearance 60 ml per minute or less) and reduced cardiac function (left ventricular ejection fraction of 40% or less).

Thirty-three percent of patients in the control group developed contrast-medium-induced nephropathy versus 15% of patients who received a standard dose of Fluimucil and 8% of patients in the high dose arm (P