A Randomized Controlled Trial of Neuroprotective Effects of N-Acetyl-Cysteine in Patients with Acute Ischemic Stroke

Background and Aim: To investigate the neuroprotective effects of NAC (N-Acetyl-Cysteine) in patients with AIS (Acute Ischemic Stroke). Materials and Methods: The study was a single blind placebo controlled trial. ۶۲ patients were enrolled in the study, ۳۱ patients in each arm. NAC was infused for the intervention group with doses of ۱۰۰ mg/kg stat on admission then ۱۰ mg/kg/hour for ۱۰ hours in addition to standard treatment. The control group only received standard treatment. The blood sample for measuring MMP-۹ (Matrix Metalloproteinase ۹) was collected from both groups before and ۲۴ hours after receiving NAC. NIHSS (National Institutes of Health Stroke Scale) was calculated for both groups before therapy, ۲۴ hours, ۲ weeks, ۱ month and ۳ months after therapy. Results: Mean NIHSS in the intervention and control groups were ۶.۸۷±۴.۱۵ and ۸.۱۱±۴.۱۲ (p-value = ۰.۲۳۱) on admission, ۴.۵۲±۳.۸۲ and ۵.۸۷±۴.۳۶ (p-value = ۰.۱۹۳)۲۴ hours after admission, ۳.۰۶±۲.۷۴and ۴.۹۳±۴.۶۹ (p-value = ۰.۰۶۱)۲ weeks later, ۲.۳۹±۲.۴۱and ۳.۶۶±۴.۹۸ (p-value = ۰.۲ ۲۵) one month later, and, ۱.۰۷±۲.۱۲and ۲.۳۶±۲.۲۸ (p-value = ۰.۵۱۱) ۳ months later respectively, which were not statistically significant. Also, the relationship between MMP۹ and NIHSS was evaluated using Pearson correlation coefficient. There was no significant correlation between MMP۹ changes and neurological deficits in any of the time intervals. In both intervention and control groups, the amount of MMP۹ ۲۴ hours after injection was decreased dramatically (p-value = ۰.۰۰۰) and showed that MMP۹ reduction was not dependent on NAC injection. Conclusion: NAC injection did not show clinical and laboratory benefits in patients with AIS in addition to standard therapy.

کلیدواژه ها:

Acetylcysteine ، Ischemia ، Stroke