Effectiveness and safety of recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction in elderly in combination with cardiac failure

Xu, Hong; Wang, Bosong; Meng, Qingmei; Li, Jinxin; Sun, Wei‐Zen; Li, Xin; Li-ping, Chen

doi:10.12669/pjms.333.12483

Cited by 7 publications

(15 citation statements)

References 14 publications

(12 reference statements)

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“…Xu et al suggested the role of BNP elevation in ACS prognosis. 15 These results corroborate our own. In previous researches, BNP was found to be a reliable and self-determining prognostic marker in subjects with all categories of ACS [16][17][18] when assessed upon arrival at the hospital.…”

Section: A H E a D O F P R I N Tsupporting

confidence: 91%

B-type natriuretic peptide as diagnostic and prognostic marker in various forms of acute coronary syndrome

Sadiq

Ijaz

Dawood³

et al. 2022

Pak J Med Sci

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Objectives: This study was conducted to evaluate the diagnostic and prognostic value of B-type natriuretic peptide (BNP) in different categories of acute coronary syndrome (ACS) patients on arrival. Methods: This cohort study included 197 patients admitted in Coronary Care Unit (CCU) of Rehman Medical Institute (RMI) Peshawar from January 2020 to June 2020. Patients were categorized in two subgroups. Subgroup-I with BNP below 100pg/mL. Subgroup-II having BNP above 100pg/mL. Samples were obtained on admission from these patients for Cardiac Troponin I (Trop-i), BNP and serum creatinine. BNP samples were analyzed on Cobas® using chemiluminescence method. Descriptive statistics were derived for age; gender and cardiac biomarkers. Receiver-operating characteristic curves (ROC) were generated. Diagnostic accuracy parameters were determined for Non ST- segment elevation myocardial infarction (STEMI), ST- segment elevation myocardial infarction (STEMI) and unstable angina (UA). Result: One hundred fourteen patients (58.2%) were males and 82 were females (41.8%).Our of this 89 patients were NSTEMI in group II. Mean BNP was 1438±1463.Age distribution shows 120 individuals were over 55 years (61.2%). Hypertension, diabetes, smoking and previous infarcts were the risk factors for ACS. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive value (NPV), likelihood ratios, and overall accuracy of BNP at admission for the entire sub categories in ACS (cut-off value 100 pg/mL) were determined by using Trop-i the gold standard. ROC curve showed AUC = 0.557, (95% confidence interval: 0.476–0.638). When Pearson correlation was applied, BNP was found to be a noteworthy independent predictor. Conclusion: BNP can be a useful Biomarker along with standard cardiac biomarkers in various categories of patients with ACS. doi: https://doi.org/10.12669/pjms.38.4.4910 How to cite this:Sadiq S, Ijaz A, Dawood MM, Sadiq T. B-type natriuretic peptide as diagnostic and prognostic marker in various forms of acute coronary syndrome. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4910 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: A H E a D O F P R I N Tsupporting

confidence: 91%

B-type natriuretic peptide as diagnostic and prognostic marker in various forms of acute coronary syndrome

Sadiq

Ijaz

Dawood³

et al. 2022

Pak J Med Sci

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“…Our previous research demonstrated that the serum concentration of NT-proBNP was significantly positively correlated with the severity of myocardial dysfunction and mortality [6]. Based on basic and clinical studies, the protective effects and safety of rhBNP administration during acute myocardial infarctions, acute heart failure, and the perioperative period of cardiac surgery have gradually been recognized, which provides the theoretical basis for our research [7,26,27]. In the present study, the administration of rhBNP significantly alleviated the severity of PRMD, myocardial inflammatory response, and myocardial tissue injuries, as reflected by improvements in MAP, ETCO 2 , EF, CO, and MPI values, myocardial inflammatory factors (IL-6 and TNF-α), serum levels of NT-proBNP, and myocardial tissue morphological injuries.…”

Section: Discussionmentioning

confidence: 90%

“…Recombinant human brain natriuretic peptide (rhBNP), a man-made peptide developed through gene engineering, has been widely used to treat acute heart failure induced by various causes. Research has suggested that rhBNP administration was able to significantly lower the serum concentrations of cardiac troponin T and NT-proBNP and improve myocardial function in patients with acute myocardial infarctions [7][8][9]. However, the protective effects of rhBNP on PRMD remain unclear.…”

Section: Introductionmentioning

confidence: 99%

The Protective Effect of rhBNP on Postresuscitation Myocardial Dysfunction in a Rat Cardiac Arrest Model

Yang

Hua

Yang

et al. 2020

BioMed Research International

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Purpose. We investigated the protective effects and the underlying mechanisms through which recombinant human brain natriuretic peptide (rhBNP) acts on postresuscitation myocardial dysfunction (PRMD) in the cardiac arrest (CA) model. Methods. Ventricular fibrillation was induced and untreated for 6 min. And the time of cardiopulmonary resuscitation was 8 min, after which defibrillation was attempted in this rat model. 24 Sprague Dawley rats (450–550g) were randomized into cardiopulmonary resuscitation (CPR) + rhBNP and CPR + placebo groups after restoration of spontaneous circulation (ROSC). rhBNP was infused at PR 30 min (loading dose: 1.5 µg/kg, 3 min; maintenance dose: 0.01 µg/kg/min, 6 h). Vital signs, ejection fraction (EF), cardiac output (CO), myocardial performance index (MPI), and 24 h survival rate were continuously recorded. The serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and N-terminal probrain natriuretic peptide (NT-proBNP) were detected by ELISA. Heart tissues were evaluated by light microscopy. The protein expression levels of myocardial inflammatory factors (IL-6 and TNF-α), Toll-like receptor 4 (TLR4), nuclear transcription factor-κB (NF-κB) subunit p65 (p65), and phosphor-p65 were analyzed by western blotting. Results. The administration of rhBNP attenuated the severity of PRMD and myocardial tissue injuries, with improvement of MAP (mean arterial blood pressure), ETCO2 (end-tidal CO2), serum level of NT-proBNP, EF, CO, and MPI values. The serum levels and protein expression levels in myocardial tissue of IL-6 and TNF-α after ROSC were reduced by inhibiting the expression of TLR4/NF-κB. Conclusion. Our research demonstrated that the administration of rhBNP attenuated the severity of PRMD and myocardial tissue injuries and increased the 24 h survival rate in this CA model. rhBNP administration also reduced the serum and myocardial tissue levels of IL-6 and TNF-α after ROSC, likely due to the suppression of the TLR4/NF-κB signaling pathway and the regulation of inflammatory mediator secretion.

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“…A total of 10 studies involving 870 participants were included in the meta-analysis. 14,[20][21][22][23][24][25][26][27][28] The study selection process is shown in Figure 1. Table 1 shows the basic characteristics of the 10 included studies.…”

Section: Literature Search and Study Selectionmentioning

confidence: 99%

Nesiritide in patients with acute myocardial infarction and heart failure: a meta-analysis

et al. 2020

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This meta-analysis evaluated the efficacy and safety of nesiritide in patients with acute myocardial infarction (AMI) and heart failure. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception through December 2018. Studies including patients with AMI and heart failure who received nesiritide were identified. Results: Ten trials involving 870 participants were included in this meta-analysis. Nesiritide treatment significantly increased left ventricular ejection fraction, cardiac index, and 24and 72-hour urine volumes. Additionally, pulmonary capillary wedge pressure, right atrial pressure, and brain natriuretic peptide and N-terminal brain natriuretic peptide levels were significantly decreased in patients treated with nesiritide compared with those treated with control drugs. However, patients treated with nesiritide did not have an increased risk of mortality compared with those treated with control drugs. There were no differences between the two groups with respect to heart rate or the risk of readmission, hypotension, or renal dysfunction. Conclusions: Nesiritide appears to be safe for patients with AMI and heart failure, and it improves global cardiac and systemic function.

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Effectiveness and safety of recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction in elderly in combination with cardiac failure

Cited by 7 publications

References 14 publications

B-type natriuretic peptide as diagnostic and prognostic marker in various forms of acute coronary syndrome

B-type natriuretic peptide as diagnostic and prognostic marker in various forms of acute coronary syndrome

The Protective Effect of rhBNP on Postresuscitation Myocardial Dysfunction in a Rat Cardiac Arrest Model

Nesiritide in patients with acute myocardial infarction and heart failure: a meta-analysis

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