Key result
N-acetylcysteine significantly reduced all-cause mortality (RR 0.56) and the occurrence of major adverse cardiovascular events (RR 0.63) compared to standard treatment in patients with STEMI.
Why the study?
The study was conducted to evaluate the clinical efficacy of N-acetylcysteine (NAC) in the treatment of ST segment elevation myocardial infarction (STEMI).
Does N-acetylcysteine reduce all-cause mortality and major adverse cardiovascular events in patients with ST segment elevation myocardial infarction?
Meta-Analysis (n=1,419)
Does N-acetylcysteine reduce all-cause mortality and major adverse cardiovascular events in patients with ST segment elevation myocardial infarction?
Relative Risk: 0.56 (95% CI 0.33–0.93)
p-value: p=0.02
In patients with STEMI, the administration of N-acetylcysteine significantly reduces all-cause mortality and major adverse cardiovascular events without increasing adverse reactions.
The aim of this study was to evaluate the clinical efficacy of N-acetylcysteine (NAC) in the treatment of ST segment elevation myocardial infarction (STEMI).PubMed, EMBASE, Cochrane Library, and Web of Science were searched systematically from the establishment of the database to June 2020. Two researchers independently completed literature screening and data extraction and conducted a meta-analysis.Nine articles including 1419 patients were enrolled. Meta-analysis showed that all-cause mortality [RR = 0.56, 95%CI (0.33, 0.93), P = 0.02], occurrence of major adverse cardiovascular events (MACE) [RR = 0.63, 95%CI (0.47, 0.85), P = 0.002], and myocardial enzyme hs-TnT level [SMD = -0.42, 95%CI (-0.71, -0.13), P = 0.005] were significantly lower in patients with STEMI treated with NAC than those in the control group. There was no significant difference between the NAC group and the control group in new congestive heart failure [RR = 0.94, 95%CI (0.48, 1.82), P = 0.84], ejection fraction [MD = 2.00, 95%CI (-0.59, 4.60), P = 0.13], and CK-MB [SMD = -0.18, 95%CI (-0.47, 0.11), P = 0.23]. There was no significant difference in the occurrence of adverse reactions between the NAC group and the control group [RR = 1.04, 95%CI (0.57-1.89), P = 0.90].NAC can reduce the all-cause mortality and MACE cases of STEMI.
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Jiang et al. (2020) conducted a meta-analysis in ST segment elevation myocardial infarction (STEMI) (n=1,419). N-acetylcysteine vs. Standard treatment/Control was evaluated on All-cause mortality (RR 0.56, 95% CI 0.33, 0.93, p=0.02). N-acetylcysteine significantly reduced all-cause mortality (RR 0.56) and the occurrence of major adverse cardiovascular events (RR 0.63) compared to standard treatment in patients with STEMI.
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