Effect of rhBNP on renal function in STEMI-HF patients with mild renal insufficiency undergoing primary PCI

Abstract

This study aims to investigate the effect of recombinant human brain natriuretic peptide (rhBNP) on renal function and contrast-induced nephropathy (CIN) incidence in ST-segment elevation myocardial infarction and heart failure (STEMI-HF) patients with mild renal insufficiency undergoing primary percutaneous coronary intervention (PCI). A total of 116 participants were randomized into rhBNP (rhBNP, n = 57) and nitroglycerin group (NIT, n = 59), receiving intravenous rhBNP or nitroglycerin from admission to 72 h after PCI. Renal function was assessed by serum creatinine (SCr), estimated glomerular filtration rate (eGFR), Cystatin-C (Cys-C) and β2-microglobulin before and after primary PCI, and calculated the incidence of CIN within 72 h after PCI. There were no significant differences in SCr, eGFR and β2-microglobulin between the two groups (P > 0.05, respectively). Compared with the NIT group, the total urinary volume within 72 h was higher while the level of Cys-C at 24 and 72 h after PCI was lower in the rhBNP group. rhBNP was associated with a decline in the incidence of CIN (12.28 vs. 28.81 %, P < 0.05). No differences were detected in mortality and re-hospitalization in 3 months between the two groups. The incidence of renal injury was not different between rhBNP and nitroglycerin in STEMI-HF patients with mild renal insufficiency. However, infusion of rhBNP was associated with a decline in incidence of CIN.

Combined impact of chronic kidney disease and contrast-induced nephropathy on long-term outcomes in patients with ST-segment elevation acute myocardial infarction who undergo primary percutaneous coronary intervention

“…A previous study has shown that a reduced contrast volume can decrease the risk of CIN [5,17], especially in patients with renal dysfunction [18]. The mean contrast volume used has been reported to range from 218 to 303 ml in previous studies assessing CIN after primary PCI for ST-segment elevation AMI [2,3,[19][20][21].…”

Effect of recombinant human brain natriuretic peptide (rhBNP) versus nitroglycerin in patients with heart failure

“…Five RCTs had a range of 1 to 6-month follow-up. In addition, 2 studies were performed in China [ 21 , 22 ] and the remaining 3 studies were conducted in the USA. [ 14 , 23 , 24 ] An RCT with >2 scores was considered to be high quality based on the Jadad scale.…”

“…The use of rhBNP had different mortality rate, with a range of 3.5% to 25.2%. [ 14 , 22 ] NIT treatment had also different mortality rate, with a range of 4.2% to 20.6%. [ 14 , 21 ] Readmission rate ranged from 7% to 61.1% in the rhBNP group.…”

“…[ 14 , 21 ] Readmission rate ranged from 7% to 61.1% in the rhBNP group. [ 22 , 23 ] Readmission rate ranged from 4.2% to 76.7% in the NIT group. [ 21 , 23 ] The highest readmission rate belonged to the result of 6-month follow-up.…”

Renal protective effect of sodium ferulate on pulmonary hypertension patients undergoing computed tomography pulmonary angiography

“…[15] Meanwhile, Qian et al reported in their research that prophylactic nitrates with matched adequate hydration is an effective strategy for CKD and CHF patients to prevent CIN. [16] Furthermore, rhBNP is effective in decreasing the incidence of CIN in patients suffering primary PCI, [17] and Acetylcysteine can be used to protect against CIN. [18] Ali-Hassan-Sayegh et al pointed out, when the patients with adequate hydration plus ascorbic acid, the incidence of CIN decreased significantly.…”