The clinical efficacy of N-acetylcysteine in the treatment of ST segment elevation myocardial infarction: A meta-analysis and systematic review

Abstract

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 estab-lishment 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.