Comparison in curative effects between recombinant human brain natriuretic peptide and nitroglycerin in treatment of acute anterior myocardial infarction complicating acute decompensated heart failure
HUANG Xin-tao
PANG Xue-min
LI Zhi-heng
BAI Bao-qiang
LI Xiao-hong
Abstract：Objective To compare curative effect and safety between recombinant human brain natriuretic peptide (rhBNP) and nitroglycerin (NTG) in treatment of acute anterior myocardial infarction (AAMI) complicating acute decompensated heart failure (ADHF).Methods The patients (n=42, male 29, female 13 aged from 18 to 75) were chosen from Mar. 2012 to Oct. 2013, and randomly divided into rhBNP group (n=20) and NTG group (n=22). The rhBNP group was given rhBNP and NTG group was given NTG besides of routine therapies for 72 h continuously. The changes of heart function grading, heart rate (HR), oxygen saturation (SpO2), 72-h urine volume (72-h RUV), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), cardiac index (CI), cardiac output (CO) and E/A were detected, and adverse reactions were recorded in 2 groups before and after treatment. The adverse cardiovascular events within 30 d were followed up.Results The total effective rate was higher in rhBNP group than that in NTG group (95.0%vs. 63.6%,P<0.05). The levels of PCWP and PAP were lower in rhBNP group than those in NTG group at all time points (allP<0.01). After treatment for 72 h, HR and respiratory rate decreased and SpO2 and 72-h RUV increased (allP<0.01), and SBP and furosemide dose decreased (allP<0.05) in rhBNP group compared with NTG group. After treatment for 72 h, LVEF [(33.52±10.47)%vs. (46.86±11.32)%], LVFS [(18.86±6.39)%vs. (22.40±6.55)%],CI [(2.24 ±0.48) L/(min·m2)vs. (2.87±0.33) L/(min·m2)], CO [(4.87±0.37) L/minvs. (5.16±0.42) L/min] and E/A [(0.85± 0.17)vs. (0.93±0.19) ] all increased in rhBNP group compared with NTG group (allP<0.05). In rhBNP group, there was 1 case with symptomatic hypotension, and in NTG group, there were 7 cases with headache and 1 with hypotension. The incidence of adverse cardiovascular events within 30 d was significantly lower in rhBNP group than that in NTG group (5% vs. 45.5%,P<0.05).Conclusion The treatment with rhBNP has effects of decreasing levels of PCWP and PAP, natriuresis, improving hemodynamics and heart function, reducing adverse cardiovascular events, and has less adverse reactions, and its curative effect and safety are higher than those of NTG.
Keywords：Recombinant human brain natriuretic peptideNitroglycerinAcute myocardial infarctionAnterior wallHeart failureCurative effect
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 704-707 )