Curative effect of low-dose dopamine combined with recombinant human brain natriuretic peptide in patients with anterior acute myocardial infarction complicated by heart failure (HF) after PCI

Li Xiufen; Maolan·Tuergan; Bilali·Aishan; Xu Lishu

doi:10.3969/j.issn.1674-4055.2018.03.18

Abstract：Objective To observe the curative effect of low-dose dopamine combined with recombinant human brain natriuretic peptide (rhBNP) and the influence on prognosis in patients with anterior acute myocardial infarction (AMI) complicated by heart failure (HF) after percutaneous coronary intervention (PCI). Methods The patients hospitalized due to acute AMI and received emergency PCI within 12 h then attacked by HF (n=108, male 70, female 38, aged from 42 to 79 and average age=58.0±12.7) were chosen from the Center of Cardiology of Hospital of Traditional Chinese Medicine affiliated to Xinjiang Medical University from June 2013 to Jan. 2016. All patients were divided randomly into control group (n=56) and test group (n=52), and given routine treatment of anti-ischemia, correcting HF and low-dose dopamine for 72 h. The test group was additionally give rhBNP for 72 h. The level of N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected before PCI and 72 h after medication. The indexes of left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were detected and calculated by using echocardiogram. The curative effect was reviewed according to clinical symptoms after 72 h. The patients were followed up for 3 months for recording re-hospitalization rate, cardiovascular events and mortality. Results The level of NT-proBNP decreased significantly in 2 groups after treatment for 72 h and the decrease was more significant in test group (all P<0.05). The comparison in LVEF, LVESV and LVEDV had no statistical significance in 2 groups before and after treatment (all P>0.05). There were 36 (64.3%) patients with significant curative effect and 12 (21.4%) with effectiveness in test group, and 17 (32.7%) with significant curative effect and 10 (19.2%) with effectiveness in control group. The total effective rate was higher in test group than that in control group (85.7% vs. 51.9%, P<0.01). After follow-up for 3 months, there were 4 (7.1%) cases of re-hospitalization, and 2 (3.6%) of cardiovascular death in test group.There were 11 (21.2%) cases of re-hospitalization, and 4 (7.7%) of cardiovascular death infarction in control group. The re-hospitalization rate was significantly lower in test group than that in control group (P<0.01). Conclusion The symptoms and prognosis are significantly relieved and improved by low-dose dopamine combined with rhBNP in patients with anterior AMI complicated by HF after PCI.