Clinical effects of different courses of recombinant human brain natriuretic peptide on patients with heart failure due to acute ST-segment elevation myocardial infarction

DING Sihua; MOU Xiaowen; WANG Xiuwei

doi:10.3969/j.issn.1006-5725.2025.23.018

Abstract：Objective To investigate the therapeutic effects of varying treatment durations of recombinant human brain natriuretic peptide(rhBNP)on heart failure following percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 196 STEMI patients with heart failure(HF)following emergency percutaneous coronary intervention(PCI)were enrolled and randomly assigned to one of four groups:control group(n=53),short-course rhBNP group(n=47),medium-course rhBNP group(n=50),and long-course rhBNP group(n=46).The rates of cardiovascular mortality and HF-related rehospitalization were evaluated at 30 days and 6 months post-treatment.Serum levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP),matrix metalloproteinase-9(MMP-9),tissue inhibitor of matrix metalloproteinase-1(TIMP-1),left ventricular end-diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)were measured at 24 hours,3 days,1 week,30 days,and 6 months after HF treatment initiation.Results Compared with the control group,both the short-and medium-term rhBNP groups showed a significant reduction in cardiovascular mortality and HF-related rehospitalization rates in the long-term rhBNP group at 30 days and 6 months(P<0.05).Additionally,the medium-term rhBNP group exhibited lower HF-related rehospitalization rates than both the control and short-term rhBNP groups(P<0.05).Serum levels of NT-proBNP,MMP-9,and LVEDD significantly decreased in the short-term rhBNP group within 24 hours compared to the control group(P<0.05),while TIMP and LVEF levels increased(P<0.05).In comparison with the short-term rhBNP group,the medium-term rhBNP group demonstrated sustained reductions in NT-proBNP,MMP-9,and LVEDD levels at 72 hours,1 week,30 days,and 6 months(P<0.05),accompanied by increases in TIMP and LVEF(P<0.05).Furthermore,the long-term rhBNP group showed greater improvements than the medium-term group,with significantly lower NT-proBNP,MMP-9,and LVEDD levels and higher TIMP and LVEF values at 1 week,30 days,and 6 months(P<0.05).In terms of the adverse reactions,the incidence of hypotension in the control group,short course rhBNP group,medium course rhBNP group and long course rhBNP group increased successively(P<0.05).Conclusion The clinical efficacy of rhBNP in STEMI patients with HF following PCI gradually improved as the treatment duration increased,but the incidence of hypotension also rose accordingly.