Evidence supporting the use of: L-Acetyl n-Cysteine
For the health condition: Congestive Heart Failure

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

L-Acetyl n-Cysteine (commonly known as N-acetylcysteine, or NAC) has been investigated for its potential role in supporting or treating congestive heart failure (CHF), primarily due to its antioxidant and vasodilatory properties. The scientific rationale centers around its ability to replenish intracellular glutathione, an important antioxidant, and to reduce oxidative stress, which is implicated in the progression of heart failure. Additionally, NAC has mild vasodilatory effects through the donation of sulfhydryl groups, which can enhance the effect of endogenous nitric oxide and potentially improve hemodynamics.

Several small clinical studies have examined NAC in heart failure patients. For example, a randomized study by Arstall et al. (1995, Circulation) found that intravenous NAC improved hemodynamic measurements in patients with acute heart failure. Another study suggested that NAC, in combination with nitroglycerin, may reduce oxidative stress and improve cardiac function in acute decompensated heart failure. However, most of the clinical evidence is from short-term, small-scale studies, often with intravenous rather than oral administration. There is a lack of large, long-term randomized controlled trials demonstrating significant clinical benefit or improved survival in CHF patients treated with NAC.

In summary, while there is a scientific rationale and some preliminary clinical data supporting the use of NAC in congestive heart failure, the evidence base is limited and not definitive. Therefore, its use in this context should be considered experimental rather than standard therapy, and the overall evidence strength is modest (rated 2/5).

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