The Game-Changing Role of NAC in Heart Health

 N-acetyl cysteine (NAC) shows promise for heart attack prevention

Heart attacks and strokes are a leading cause of death in developed countries - accounting for ~20% of all deaths in the U.S. Frequently, heart attacks and strokes are caused by blood clots (blood platelets that form when they are not needed, causing a narrowing/blockage of blood vessels) formed through arterial thrombosis. Current antiplatelet agents (e.g., aspirin) are effective but can increase major bleeding risk. As such, there is a growing need to prevent arterial thrombosis different from antiplatelet agents.

A recent study published in Arteriosclerosis, Thrombosis, and Vascular Biology investigated the potential of NAC as an agent to prevent arterial thrombosis. Utilizing both [cell-based] human blood models and mouse (in vitro) models, the research demonstrated that NAC significantly delayed and even prevented thrombus formation dose-dependently without increasing bleeding risks.

Findings:
*NAC treatment extended clot formation times by up to 3.7 times compared to controls in the human blood [cell] model.
*NAC entirely inhibited platelet aggregation and occlusive clot formation at higher doses than the above point in the cell model.
*A 400 mg/kg (via injection in rodents) dose of NAC in mice effectively prevented arterial occlusion post-injury.
*Lower doses (200 mg/kg - via injection in rodents) of NAC reduced clot stability, suggesting working as both an acute and preventative clotting therapy.

The study showed that NAC interferes with von Willebrand factor (a large protein crucial for blood clotting) activity. NAC acts against VWF rather than platelets to prevent clot formation. Thus, providing a safer alternative to traditional antiplatelet drugs that carry higher bleeding risks. 

Transcript

Speaker 0: 0:00

Hello everyone, Welcome back to the channel. Today, we're going to be looking at a study published in the American Heart Association Journal Arteriosclerosis, Thrombosis and Vascular Biology, which explored the potential of N-acetylcysteine, or NAC, in preventing arterial thrombosis. In other words, the potential of NAC to prevent clots blood clots in arteries. Now, if that sounds intriguing to you, be sure to stick around, because I'll also be sharing some unique insights into NAC and its broader implications for health. Before we get started, I do want to remind everyone that this video is for educational purposes only and it does not constitute medical advice. So please consult with your healthcare provider before making any changes to any health regimen. So what exactly is arterial thrombosis and why should we care about it?

Speaker 0: 0:50

Arterial thrombosis occurs when blood clots form in the arteries, which can lead to serious conditions like heart attacks and strokes. These events are leading causes of death worldwide, responsible for about 20% of all deaths in the United States alone. Traditionally, we've relied on antiplatelet drugs like aspirin and clopidogrel to prevent these clots. However, medications come with their own side effects, that being a significant risk of bleeding. In this sense, doctors are being put between a rock and a hard place, where they can give you a drug that may help prevent a second cardiac event, but it might also cause a lot of bleeding, or at least increase the risk of it. That brings us to the potential of NAC, a compound that might offer a safer alternative. Nac is a derivative of the amino acid cysteine and is known for its antioxidant properties. Actually, many people watching this video likely know it's the limiting precursor, or the rate-limiting precursor, for glutathione synthesis. Nac has been used for years to treat conditions like acetaminophen overdose and chronic respiratory diseases, due to its ability to replenish glutathione levels in the body, among other things, which we'll talk about in a bit.

Speaker 0: 2:07

But this new study by Bresset et al suggests another potential use preventing arterial thrombosis without the major bleeding risks associated with traditional antiplatelet drugs. Now, in this study, the researchers tested NAC's ability to prevent blood clot formation, both in vitro this was using human blood in a lab setting and in vivo this was using a mouse model. They found that NAC could significantly delay the formation of blood clots in a dose-dependent manner. In simpler terms, the more NAC was used, the longer it took blood clots to form. One of the standout findings was that human blood treated with 10 millimoles per liter of NAC did not form an occlusive clot at all during the test period. This is a pretty remarkable finding because it does suggest that NAC could effectively prevent the formation of dangerous clots. Suggest that NAC could effectively prevent the formation of dangerous clots In the mouse model. An injection dose of 400 milligrams per kilos of body weight of NAC prevented occlusive clots without significantly affecting bleeding times. That's important because it indicates that NAC can inhibit clot formation without increasing the risk of bleeding, the major drawback of current antiplatelet therapies.

Speaker 0: 3:26

So how does NEC work, differently from current antiplatelet treatments? Well, certain types of blood clots are held together by a protein called von Willebrand factor. Essentially, von Willebrand factor grabs platelets by acting in a similar fashion to flypaper. When it has hold of the platelets, they can activate and release more von Willebrand factor, which grabs more platelets, creating a positive feedback loop that leads to really fast clot formation. Nac is what is called a reactive theole, meaning that it can break apart disulfide bonds, which are basically two sulfur molecules that are bound together. That's in part, why NAC is prescribed as an anti-muco-inhalant medication. When NAC is inhaled, the mist cleaves the disulfide bonds of mucus, which shortens mucus length and loosens mucus. Von Willebrand factor and mucus are structurally similar, which allows NAC to work in a similar fashion on von Willebrand factor to how it does mucus. This mechanism is different from that of traditional antiplatelet drugs, which directly target platelets and increase bleeding risk by acting on von Willebrand factor. Instead, NAC offers a promising alternative that could prevent clots without compromising the body's ability to stop bleeding.

Speaker 0: 4:47

Nac is already available as an over-the-counter supplement, but the doses used in this study are much higher than what you typically find in a supplement. Administration of NAC in this study was via injection, and when you look at the blood levels of NAC achieved through the injection dose and consider not only the human equivalent dosing but the oral bioavailability of NAC being between 4 and 10 percent, then you'd conclude that it's not reasonable to get that amount of NAC to be effective here orally. High doses of NAC can cause side effects like nausea, vomiting, diarrhea, etc. Therefore, any use of NAC for preventing blood clotting in someone who is high risk for clotting would likely be done under medical supervision using NAC in an injection format. So, in conclusion, this study highlights a promising new role for NAC in cardiovascular health. Its ability to prevent blood clotting without significantly increasing bleeding risk could make it a valuable tool in managing heart attack and stroke risk.

Speaker 0: 5:52

As always, more research in this area is needed, especially human clinical trials, to help fully understand its potential as well as its safety profile. So what can you take away from this? Firstly, NIC might be an important player in the future of cardiovascular health, offering a safer alternative to traditional antiplatelet drugs. Secondly, always consult your healthcare provider before starting any new supplement, especially at higher doses. A new supplement, especially at higher doses. So I do thank you for the time that you have given me here. If you found this video informative or helpful in any way, please give it a thumbs up and consider subscribing, as that does help me out. Until next time, stay healthy.