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

Abstract

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.

Effects of Recombinant Human Brain Natriuretic Peptide on Atrial Fibrillation After Coronary Artery Bypass Grafting

“…[21][22][23] During rh-BNP infusion, hypotension is the most common complication. 24,25 In this trial, the incidence of hypotension in the non-rh-BNP group was slightly higher than in the rh-BNP group, and there was no significant difference in hypotension between the 2 groups. In a study 26 of 44 children after total cavopulmonary connection, no refractory hypotensive events were observed with rh-BNP infusion.…”

Current Modulation of Guanylate Cyclase Pathway Activity—Mechanism and Clinical Implications

“…Perioperative low-dose carperitide infusion was found useful in high-risk patients undergoing on-pump CABG [ 58 ]. Zhao et al [ 59 ] prepared a meta-analysis of the efficacy and safety of nesiritide in patients with acute myocardial infarction and heart failure. The results of trials involving 870 participants were included in the meta-analysis.…”

“…Additionally, pulmonary capillary wedge pressure, right atrial pressure and BNP and N-terminal brain natriuretic peptide (NT-proBNP) levels were significantly decreased in patients treated with nesiritide, compared with those treated with control drugs (“control drugs” were optimal pharmacotherapy according to guidelines). The authors concluded that nesiritide appeared to improve cardiac function and, moreover, was safe for patients [ 59 ]. The results of large clinical trials presented by O’Conor et al in 2011 failed to show a difference between nesiritide and placebo on mortality or rehospitalization rate in this group of patients [ 60 ].…”