Prevention of Serious Adverse Events Following Angiography

Inclusion Criteria: * Planned elective or urgent coronary or non-coronary angiography with iodinated contrast media in which it is anticipated that there will be an interval of 3 hours between the identification of the indication for angiography and the time of the planned procedure. * Pre-angiography eGFR \<60 ml/min/1.73 m2 with diabetes mellitus or pre-angiography eGFR \<45 ml/min/1.73 m2 with or without diabetes mellitus * Ability to provide informed consent Exclusion Criteria: * Stage 5 chronic kidney disease (CKD) (eGFR \<15 mL/min/1.73 m2) * Currently receiving hemodialysis, peritoneal dialysis, continuous renal replacement therapy, or sustained low efficiency dialysis (SLED) * Unstable baseline serum creatinine (SCr) (if known) at the time of angiography defined by an increase in SCr of 25% over the 3 days prior to angiography * Decompensated heart failure requiring any of the following therapies at the time of angiography: * IV milrinone, amrinone, dobutamine, or nesiritide * Isolated ultrafiltration therapy * Intra-aortic balloon pump * Emergent angiography procedures defined as an anticipated duration of \<3 hours between the identification of the indication for angiography and the time of the planned procedure. * Receipt of intravascular iodinated contrast within the 5 days preceding angiography * Receipt of oral or IV NAC within the 48 hours preceding angiography * Known allergy to N-acetylcysteine (NAC) * Known anaphylactic allergy to iodinated contras…