ASSA14-01-04 Impact of rhBNP on reperfusion injury in the patients with acute myocardiac infarction undergoing emergency percutaneous coronary intervention

Objective

To investigate the effect of Lyophiluzed Recombinant Human Brain Natriuretic Peptide (rhBNP) on myocardiac reperfusion injury in the patients with ST-segment elevation myocardial infarction (STEMI) of anterior wall undergoing emergency percutaneous coronary intervention (PCI).

Methods

This prospective study included patients with acute STEMI of anterior wall undergoing emergency PCI hospitalised at Affiliated Zhongshan Hospital of Dalian University from March 2013 to June 2014. Patients with SBP < 100 mmHg, culprit vessel blood flow of TIMI 2–3 before PCI, and renal insufficiency were excluded. 56 patients were randomly divited into rhBNP group (n = 25) and control group (n = 31). In the rhBNP group, rhBNP was injected by intravenous with 1.5 ug/kg between 3 min and 5 min followed with continuous infusion of 0.01 ug^-1 · min^-1, and the totle dose of rhBNP was 0.5 g in each patient. Other procedures of rhBNP group were similar with those of control group. Patients’ demographic, clinical and angiographic characteristics were obtained. The supemxide dismutase (SOD), malonaldehyde (MDA) and high sensitivity C-reactive protein (hsCRP) were measured. The parameters presenting myocardial infusion including corrected TIMI framecount (CTFC) and myocardial blush grade (MBG) were calculated. The reperfusion arrhythmia was recorded. Left ventricular ejection fraction (LVEF) of the recruited patients was assessed at 3 days and 6 weeks after emergency PCI.

Results

The serum levels of MDA and hsCRP were significantly lower, and serum SOD level was significantly higher in rhBNP group than those in control group (all p < 0.05). Compared with control group, CTFC was significantly lower in rhBNP group (p < 0.05). The MBG ≥ grade 2 was more common, and incidence of reperfusion arrhythmias was less common in rhBNP group than those in control (all p < 0.05). RhBNP group patients’ LVEF was higher than that in control group at both 3 days and 6 weeks after emergency PCI. No significant differences including age, gender, hypertension, diabetes, hyperlipidemia, history of previous myocardial infaction, blood pressure and heart rate before PCI, time from onset to balloon, diseased vessel number and culprit lesion site were observed between the two groups.

Conclusion

RhBNP can effectively reduce myocardial ischemia-reperfusion injury in pantients with STEMI of anterior wall after emergency PCI.