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The mitochondrial DOX-Fe 2+ complex induces triggers lipid peroxidation, resulting in mitochondria-dependent ferroptosis and decreased cardiac function in mice, which is reflected in significantly reduced left ventricular ejection fraction and myocardial fibrosis

Patients who have had such reactions to previous therapy with acetylcysteine may not react during subsequent therapy with the drug, and patients who have had inhalation treatments with acetylcysteine without incident may react to subsequent therapy

Science 337 , 14991501 (2012)

If GPX4 activity is inhibited, lipid peroxides can accumulate

Angelini G, Gardella S, Ardy M, et al