Fresh Science

A common drug could drastically reduce the damage caused by heart attacks, a new study has shown.

“This could change the way heart attacks are treated worldwide,” says researcher Sivabaskari Pasupathy, who carried out the study with colleagues at the University of Adelaide and the Heart Foundation of Australia. “We believe the decrease in heart damage may lead to significant improvement in patients’ outcomes.”

Heart attacks are common cardiac emergencies and remain a major health concern globally despite huge advances in treatment.

They usually occur when an artery supplying the heart muscle is blocked by a blood clot, which quickly leads to the death of oxygen-deprived heart cells and damage to heart muscles.

Current treatment is focused on limiting heart muscle damage by re-opening the blocked coronary artery with a balloon or stent. Re-opening the artery can reduce heart muscle damage by up to half.

Evidence also suggests additional damage may occur after the re-opening. This additional damage is referred as reperfusion injury, and scientists think that oxidative stress— occurring when oxygen is reintroduced to the tissue—is one of the major factors.

N-acetylcysteine is a common drug with antioxidant properties that could potentially minimise reperfusion injury by reducing oxidative stress arising from re-opening of the artery. Furthermore, when administered together with glyceryl trinitrate (GTN), N-acetylcysteine provides additional benefits such as widening the arteries and preventing blood clot formation.

The NACIAM (N-AcetylCysteine In Acute Myocardial infarction) trial was carried out in 112 heart attack patients in three South Australian hospitals. The study treatment (combined N-acetylcysteine and GTN therapy) was initiated intravenously in the emergency department and continued for the first two days of admission.

“We found that the size of the damaged area was reduced by about 30 per cent and the heart muscle surviving the heart attack increased by about 50 per cent in patients who received the study treatment compared to those who didn’t. No adverse effects were recorded as a result of the study drug administration, highlighting the safety of this therapy,” says Sivabaskari.

“We have demonstrated that the early use of these agents reduces heart muscle damage. However, we still have to wait for a large clinical outcome-driven trial before we might see the widespread utilization of this novel treatment strategy.”

Banner image credit: University of Adelaide