N-Acetylcysteine Protection Against Radiation Induced Cellular Damage

NCT ID: NCT04154982

Last Updated: 2025-08-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

181 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-02

Study Completion Date

2024-12-02

Brief Summary

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Catheter ablation procedures (CAPs) are first line treatment for a great variety of cardiac arrhythmias. CAPs require X-Ray imaging; consequently, CAPs cause ionizing radiation (IR) exposure for patients. Exposure to IR, even at low-doses, increases individual risk of developing cancer. IR cause DNA damage directly and, mostly, indirectly by formation of cellular free radicals. Furthermore different response to IR results from inherited variants in genes involved in DNA damage repair. N-acetylcysteine (NAC) is an aminoacid that can directly neutralize free radicals and increase antioxidant systems. Our preliminary data suggest that IR exposure in patients undergoing CAP deranges the oxidative stress status and the pre-procedure intravenous administration of NAC could decrease such abnormality.

Detailed Description

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CARAPACE is a prospective, randomized, single-blinded, parallel-arm monocenter study. Eligible patients undergoing CAP at the Arrhythmology Unit of Centro Cardiologico Monzino will be enrolled.

The hypothesis driving our study, based on published literature and our preliminary data, is that administration of antioxidant agents, before cardiac procedures involving IR exposure, might prevent IR harmful effects on human tissues in terms of reduction of systemic oxidative stress status and, in parallel, of oxidative DNA damage.

The antioxidant agent tested in our study is NAC. NAC is a well-tolerated and safe medication and it has antioxidant properties is based on three main mechanisms: 1) direct antioxidant effect, 2) glutathione (GSH) precursor action, and 3) its activity in breaking thiolated proteins.

Another hypothesis to be tested is whether genes involved in DNA damage repair could explain the great variability in patient radiosensitivity to IR exposure and whether these genes could affect NAC protective/healing effects.

Conditions

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Cardiac Arrhythmia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Researchers, involved in the assessment of NAC efficacy, are blinded to randomization process; thus, they do not know whether the patients are in the NAC or in the control groups.

Study Groups

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Pharmacological treatment

Patients are treated with NAC prior to carrying out CAP.

Group Type EXPERIMENTAL

Acetyl cysteine

Intervention Type DRUG

1200 mg of NAC are intravenously administrated 1 hour prior to carrying out CAP.

Standard procedure

Patients are not treated with NAC. No placebo treatment is performed.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Acetyl cysteine

1200 mg of NAC are intravenously administrated 1 hour prior to carrying out CAP.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patient's age \>18 years.
* Negative hCG pregnancy test (if appropriate).
* Indication to perform CAP guided by fluoroscopy (IR imaging).
* Ability and willingness to give informed consent and to comply with protocol.

Exclusion Criteria

* Any contraindication to CAP (such as, pregnancy and breastfeeding).
* Hypersensitivity to the active substance or to any of the excipients.
* Enrollment in another study that may interfere with CARAPACE study.
* Administration of an experimental drug within 30 days or 5 half-lives of the investigational drug.
* Chronic kidney disease (serum creatinine \>1.5 mg/dl).
* Acute/Chronic inflammatory disease.
* Antioxidant drugs intake over the previous 2 weeks.
* History of radiotherapy or chemotherapy in the last year.
* Any documented condition that, in PI's motivated judgement, makes the patient a poor candidate for the study.
* Computed tomography and/or coronary angiography within 5 days prior to baseline analysis.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health, Italy

OTHER_GOV

Sponsor Role collaborator

Centro Cardiologico Monzino

OTHER

Sponsor Role lead

Responsible Party

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Claudio Tondo

Deputy of Heart Rhythm Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Centro Cardiologico Monzino

Milan, MI, Italy

Site Status

Countries

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Italy

References

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Related Links

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http://doi.org/10.1016/j.jacc.2018.02.017

Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging

http://doi.org/10.17226/11340

National Research Council. 2006. Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press.

Other Identifiers

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CCM1006

Identifier Type: -

Identifier Source: org_study_id

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