Effect of Oral N-Acetylcystein on Galectin-3 in Acute Myocardial Infarction Patients

Authors

  • Akhmad Jalaludinsyah Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta
  • Trisulo Wasyanto Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta
  • Niniek Purwaningtyas Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta

Abstract

Background: The pathogenesis of heart failure after myocardial infarction is associated with the pathogenesis of cardiac remodeling. Galectin-3 (Gal-3) has a role in the pathophysiology of cardiac remodeling after acute myocardial infarction. N-Acetylcysteine (NAC) can prevent inflammation, remodeling and left ventricular dysfunction, interstitial fibrosis, and improve survival. The purpose of this study was to examine the effect of oral N-Acetylcysteine on Galectin-3 in acute myocardial infarction patients.

Subjects and Methods: This was an experimental study with pre and post, single-blind, and randomization methods. The study was conducted at Dr.Moewardi General Hospital Surakarta, Central Java, from June to August 2018. A sample of 29 acute myocardial infarction patients with ST-segment elevation who received fibrinolytic therapy was selected for this study. 14 patients as a control group received standard therapy and 15 patients as intervention group received oral NAC supplementary therapy 600 mg three times daily for three days. The dependent variable was Gal-3 levels. The independent variable was NAC supplementary therapy. The data were analyzed by Mann Whitney test.

Results : Gal-3 levels in intervention group (mean= 8.95; SD=1.76) were lowered than the control group (mean= 11.42; SD= 3.76) and it was statistically significant (p= 0.026).

Conclusion: Supplementary therapy of NAC 600 mg orally 3 times a day for 3 days can reduce levels of Gal-3 in patients with acute myocardial infarction who receive fibrinolytic therapy.

Keywords: galectin-3, n-acetylcysteine, acute myocardial infarction 

Correspondence: Akhmad Jalaludinsyah. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: dokter.akhmad@gmail.com. Mobile: +6281393098987.

Indonesian Journal of Medicine (2019), 4(1): 1-8
https://doi.org/10.26911/theijmed.2019.04.01.01

References

Atkuri KR, Mantovani JJ, Herzenberg LA, et al. (2007). N Acetylcysteine a safe antidote for cysteine/glutathione defi-ciency. Curr Opin Pharmacol. 7: 355 -3599. doi: 10.1016/j.coph.2007.04.005  Crossref  PubMed  Google Scholar 

Christia P, Frangogiannis NG (2013). Targeting inflammatory pathways in myocardial Infarction. Eur J Clin Invest. 43(9): 986–995. doi: 10.1111/eci.12118  Crossref  PubMed  Google Scholar 

Dharma S, Juzar DA, Firdaus I, et al. (2012). Acute myocardial infarction system of care in the third world. Neth Heart J. 20(6): 254–259. doi: 10.1007/s12471-012-0259-9  Crossref  PubMed  Google Scholar 

di Tano G, Caretta G, Maria RD, et al. (2017). Galectin-3 and outcomes after anterior wall myocardial infarction treated by primary percutaneous coronary intervention. Biomark Med. 12(1):21-26. doi: 10.2217/bmm-2017-0178  Crossref  PubMed  Google Scholar 

di Tano G, Caretta G, Maria RD, et al. (2017). Galectin-3 predicts left ventricular remodelling after anterior wall myocardial infarction treated by primary percutaneous Coronary Intervention. Heart. 103: 71–77. doi: 10.1136/heartjnl-2016-309673  Crossref  PubMed  Google Scholar 

Fan H, Sun B, Gu Q, et al. (2002). Oxygen radicals trigger activation of NF-kappaB and AP-1 and upregulation of ICAM-1 in reperfused canine heart. Am J Physiol Heart Circ Physiol. 282: H1778–1786. doi: 10.1152/ajpheart.00796.2000  Crossref  PubMed  Google Scholar 

Ibanez B, James S, Agewall S, et al. (2017). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 39:119–177. doi: 10.1093/eurheartj/ehx393  Crossref  PubMed  Google Scholar 

Meijers WC, van der Velde AR, Pascual-Figal DA, et al. (2015). Galectin-3 and post myocardial infarction cardiac remodeling.Eur J Pharmacol. 763: 115-21. doi: 10.1016/j.ejphar.2015.06.025  Crossref  PubMed  Google Scholar 

Pasupathy S, Tavella R, Grover S, et al. (2017). Early use of N-Acetylcysteine (NAC) with nitrate therapy in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction reduces myocardial infarct size (The NACIAM Trial). Circulation; 136(10): 894-903. doi: n 10.1161/CIRCULATIONAHA.117.027575  Crossref  Google Scholar 

Pinkus R, Weiner LM, Daniel V (1996). Role of oxidants and antioxidants in the induction of AP-1, NF- κ B, and glutathione S-transferase gene expression. J Biol Chem. 271: 13422 -9. doi: 10.1074/jbc.271.23.13422  Crossref  PubMed  Google Scholar 

Pfeffer MA, Braunwald E (1990). Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circulation; 81: 1161–72. doi: 10.1161/01.cir.81.4.1161  Crossref  PubMed  Google Scholar 

Radomska DM, Skopiñski P (2012). N-acetylcysteine as an anti-oxidant and anti-inflammatory drug and its some clinical applications.Centr Eur J Immunol. 37 (1): 57-66. Google Scholar 

Sharma UC, Mosleh W, Chaudhari MR, et al. (2016). Myocardial and Serum Galectin-3 Expression Dynamics Marks Post Myocardial Infarction Cardiac Remodeling. Heart Lung Circ. 26(7): 736-745. doi: 10.1016/j.hlc.2016.11.007  Crossref  PubMed  Google Scholar 

Sugiura H, Ichikawa T, Liu X, et al. (2009). N-acetyl-L-cysteine inhibits TGF-beta1-induced profibrotic responses in fibroblasts. Pulm Pharmacol Ther. 22: 487–91. doi: 10.1016/j.pupt.2009.04.002  Crossref  Google Scholar 

Talasaz AH, Khalili H, Fahimi F, et al. (2011). Potential role of N-acetylcys-teine in cardiovascular disorders. Therapy. 8(3): 37–245. doi: 10.2217/THY.11.12  Crossref  Google Scholar 

Talasaz AH, Khalili H, Jenab Y, et al. (2013). N-Acetylcysteine effects on transforming growth factor-β and tumor necrosis factor-a serum levels as pro-fibrotic and inflammatory biomarkers in patients following ST-segment elevation myocardial infarction. Drugs R D. 13:199–205. doi: 10.1007/s40268-013-0025-5  Crossref  PubMed  Google Scholar 

Talasaz AH, Khalili H, Fahimi F, et al. (2014). Effects of N-Acetylcysteine on the cardiac remodeling biomarkers and major adverse events following acute myocardial infarction: A randomized clinical trial. Am J Cardiovasc Drugs. 14:51–61. doi: 10.1007/s40256-013-0048-x  Crossref  PubMed  Google Scholar 

van der Velde AR, Lexis CPH, Meijers WC, et al. (2016). Galectin-3 and sST2 in prediction of left ventricular ejection fraction after myocardial infarction. Clin Chim Acta. 452: 50-7. doi: 10.1016/j.cca.2015.10.034  Crossref  PubMed  Google Scholar 

Velagaleti RS, Pencina MJ, Murabito JM, et al. (2008). Long-term trends in the incidence of heart failure after myocardial infarction. Circulation. 118: 2057–62. doi: 10.1161/CIRCULATIONAHA.108.784215  Crossref  PubMed  Google Scholar 

Waard MC, Velden J, Boontje NM, et al. (2009). Detrimental effect of combi-ned exercise training and eNOS over-expression on cardiac function after myocardial infarction.Am. J. Physiol. Heart Circ. Physiol. 296(5): 1513–1523. doi: no doi  Crossref  PubMed  Google Scholar 

Daftar Pustaka dengan DOI. doi: 10.1152/ajpheart.00485.2008  Crossref  PubMed  Google Scholar 

White HD, Chew DP (2008). Acute myocardial infarction. Lancet. 372(9638): 570–584.

Yang RY, Rabinovich GA, Liu FT (2008). Galectins: Structure, function and therapeutic potential. Expert Rev Mol Med. 13: e17–e39. doi: 10.1017/S1462399408000719  Crossref  PubMed  Google Scholar 

Yu L (2012) The role of Galectin-3 in cardiac remodeling and fibrogenesis. Groningen. Website

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2019-01-01

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