Objective To study the efficacy and safety of recombinant human B-type natriuretic peptide (rhBNP) in AMI-ADHF patients undergoing PCI, especially changes in renal function and the impact of short-term outcome during BNP treatment.
Methods 87 consecutive patients with AMI-ADHF entrolled in the study. All patients were randomly assigned to the rhBNP group and control group. rhBNP was given at 1.5 μg kg−1 intravenously and then infused intravenously (0.0075–0.030 μg kg−1 min−1). 0.9% Saline was used intravenously in control group as control. Clinical symptoms and killip grade were recorded. Plasma BNP levels were measured before and after stopping the drug 6h, 14d, 30d. LVEDD and LVEF was measured. Serum creatinine (Scr) was measured before and after administered the medication 24 h, 48 h, 72 h, 7 days and 14 days using simplified MDRD equation to calculate estimated glomerular filtration rate (eGFR). Recording the major adverse cardiac events (MACE) occurrence within 30 d.
Results rhBNP group has a less dyspnoea time than the control group; The plasma BNP levels significantly lower than before treatment at different time point in the two groups. The LVEF was significantly higher in treatment group compared with baseline levels after treatment 24 h, while LVEDD significantly decreased even after discontinuation the treatments, which remain so when the 30 days. The LVEF and LVEDD improvements in rhBNP group were significantly better than in the control group after treatment 24 h, 14 days; At day 7 after PCI, the SCr had lowered to the baseline level in the rhBNP group. The eGFR after PCI was higher in the rhBNP group than that in the control group. The occurrence of CIN was signicantly lower in the rhBNP group than in the control group. The MACE event of 30 days in rhBNP group was significantly lower than the control group.
Conclusion rhBNP can promptly and effectively improve the heart function, reduce the incidence of MACE rate in acute myocardial infarction with heart failure patients, which also had a renal function protective effect in patients with and decreased incidence on CIN.