Efficacy and safety of recombinant human B-type natriuretic peptide on acute systolic heart failure patients with acute anterior myocardial infarction

Objective To investigate the efficacy and safety of recombinent human B-type natriuretic peptide (rhBNP) on systolic heart failure (SHF) resulted from acute anterior myocardial infarction (AAMI) in the elderly. Methods 87 patients with AAMI-SHF were randomly divided into the rhBNP and nitroglycerin (NTG) groups. rhBNP was given at 1.5 μg/kg intravenously and then infused intravenously (0.007 5~0.030 μg·kg-1·min-1). NTG was used intravenously in NTG group as control (10~100 μg/min). Both drugs were administered for 24 h. Blood samples were collected at different time points to investigate TnI,BNP,serum creatinine and other biochemic parameters. Glomerular filtration rate (GFR) was calculated according to the simplified equation of MDRD formula.Ultrasonic cardiography (UCG) was performed before the initiation of the infusion,at day 1,14 and 30 after the infusion. All patients were followed up for 1 month to record the main adverse cardiac events (MACEs). Results Clinical characteristics of heart failure were all improved much more in rhBNP group than that of NTG group. Left ventricular ejection fraction (LVEF) was raised at 24 h in both groups and it was raised much more in rhBNP group. Left ventricular end-diastolic dimension (LVEDD) was decreased significantly at 24 h in both groups and it was decreased much more in rhBNP group. Concentration of plasma BNP was significantly reduced in both groups and there was significant difference between 2 groups. GFR was lowered in both 2 groups at 1 day. At 3 day,GFR rebounded to baseline value. At 7 day,GFR was higher than baseline. There was no difference between 2 groups at different time point. The rate of ventricular arrhythmia was fewer within 7 days in rhBNP group than that of NTG group. MACEs were lower in rhBNP group at 14 and 30 d than those of NTG group. Conclusions rhBNP can improve the heart function of old patients with AAMI-SHF,reduce the rate of the MACEs of AAMI-SHF within 30 days,and has no significant effect on patients renal function.