Effects of recombinant human brain natriuretic peptide on the prognosis of patients with acute anterior myocardial infarction undergoing primary percutaneous coronary intervention: a prospective, multi-center, randomized clinical trial

被引:23
作者
Miao, Zhi-Lin [1 ]
Hou, Ai-Jie [1 ]
Zang, Hong-Yun [2 ]
Huang, Ru-Gang [3 ]
Zheng, Xiao-Qun [4 ]
Lin, Hai-Long [4 ]
Wang, Wei [5 ]
Hou, Ping [6 ]
Xia, Fei [1 ]
Li, Zhan-Quan [1 ]
机构
[1] Peoples Hosp China Med Univ, Peoples Hosp Liaoning Prov, Dept Cardiol, No 33 Wenyi Rd, Shenyang 110016, Peoples R China
[2] Dept Cardiol, 463rd Hosp PLA, Shenyang 110042, Peoples R China
[3] Tieling Cent Hosp, Dept Cardiol, Tieling 112000, Peoples R China
[4] Dalian Municipal Cent Hosp, Dept Cardiol, Dalian 116013, Peoples R China
[5] Dandong Cent Hosp, Dept Cardiol, Dandong 118002, Peoples R China
[6] Univ Tradit Chinese Med, Hosp Liaoning, Dept Cardiol, Liaoning 110032, Peoples R China
关键词
Acute anterior myocardial infarction; percutaneous coronary intervention (PCI); recombinant human brain natriuretic peptide; N-terminal pro-brain natriuretic peptide (NT-proBNP); major adverse event; PREDICTIVE-VALUE; HEART-FAILURE; MICE; ANGIOPLASTY; ALDOSTERONE; NESIRITIDE; FIBROSIS; BNP;
D O I
10.21037/jtd.2017.01.15
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: This study aims to investigate the effects of recombinant human brain natriuretic peptide (rhBNP) on serum enzyme data, cardiac function parameters and cardiovascular events in patients with acute anterior myocardial infarction (MI). Methods: A total of 421 patients with acute anterior or extensive anterior MI were collected from 20 hospitals. These patients were randomly divided into two groups: rhBNP and control groups. Both groups of patients received primary percutaneous coronary intervention (PCI) within the effective time window. In the rhBNP group, rhBNP administration (0.01 mu g/kg/min, 48-72 successive hours) was performed as early as possible after hospital admission. Prior to and one or seven days after PCI, serum concentrations of cardiac troponin (cTnT), creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured. At seven days and 6 months after PCI, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd) and stroke volume (SV) were measured using 2D Doppler echocardiography. MACEs that occurred during hospitalization and within 6 months after PCI were recorded. Results: At postoperative days one and seven, serum concentrations of cTnT were significantly lower in the rhBNP group than in the control group. At postoperative day one, serum concentrations of CK-MB were significantly lower in the rhBNP group than in the control group. At postoperative day seven, serum concentrations of NT-proBNP were significantly lower in the rhBNP group than in the control group, and LVEF was significantly greater in the rhBNP group than in the control group. At postoperative 6 months, LVEDd was significantly lower in the rhBNP group compared with the control group. In addition, SV and LVEF were significantly greater in the rhBNP group than in the control group. By postoperative month 6, the incidence of composite cardiovascular events (16.0% vs. 26.0%, P=0.012), cardiac death (7.0% vs. 13.5%, P=0.030), and particularly cardiac death + re-hospitalization for congestive heart failure (13.1% vs. 25.5%, P=0.001) were significantly lower in the rhBNP group than in the control group. Conclusions: Early intravenous rhBNP administration after PCI significantly lowered the serum concentrations of cTnT and NT-proBNP, increased LVEDd, SV and LVEF, and reduced MACEs, including cardiac death, in patients with acute anterior MI undergoing PCI.
引用
收藏
页码:54 / +
页数:11
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