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

Abstract

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 µg/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.

Prognostic implication of glomerular filtration rates in patients with chronic thromboembolic pulmonary hypertension who have undergone balloon pulmonary angioplasty

“…In addition to expanding the coronary and lung circulation, BNP reduces myocardial oxygen consumption and increases coronary blood flow, which prevents cardiac remodeling (34,35). The present study revealed that the serum levels of troponin I and NT-proBNP were significantly decreased in the GFR >53 group at final follow-up.…”

Effects of Recombinant Human Brain Natriuretic Peptide in Patients of Chronic Thromboembolic Pulmonary Hypertension with Chronic Kidney Disease Who Underwent Balloon Pulmonary Angioplasty

“…The therapeutic effect of rhBNP in the clinical management of cardiac diseases is well recognized [23]. BNP is a natural factor against cardiac remodeling, and selectively expands coronary and lung circulation, increases coronary blood ow and reduces the consumption of myocardial oxygen [24,25]. Our results revealed that rhBNP signi cantly decreased the serum concentrations of TnI and NT-proBNP in follow-up.…”

Effect of creatine kinase isoenzyme (CK-MB) on early prognosis after off-pump coronary artery bypass grafting.

“…The related data show that the blood flow of the bridge is positively correlated with the diameter of the distal coronary artery. When there is stenosis or obstruction of the distal vessel, the anastomotic site is not unobstructed and the blood flow is small 14 . The positive correlation between the diameter of the distal target vessel > 1.5mm and the increase of CK-MB may be due to the decrease of blood flow caused by a large vascular plaque load, which in turn affects the increase of CK-MB level 15 each of whom presented with a normal ECG and was subjected to emergency coronary angiography (CAG).…”