Protective effect of recombinant human brain natriuretic peptide against contrast-induced nephropathy in elderly acute myocardial infarction patients: A randomized controlled trial

Abstract

BACKGROUND Increasing reports have demonstrated that recombinant human brain natriuretic peptide (rhBNP) can improve acute myocardial infarction (AMI) and heart failure. However, whether it can improve renal function and decrease the risk of contrast-induced nephropathy (CIN) in elderly AMI patients is still unclear. AIM To explore the effect of rhBNP on CIN in elderly AMI patients after percutaneous coronary intervention (PCI). METHODS One hundred and thirty-one elderly AMI patients underwent PCI from January 2017 to July 2021. Patients were either given 1 mL of 0.9% normal saline/(kg/h) for 72 h after PCI (control group, n = 66) and or intravenous rhBNP [1.5 mg/kg followed by 0.0075 mg/(kg/min)] for 72 h (rhBNP treatment group, n = 65). Serum creatinine and cystatin C levels, creatinine clearance rate, and eGFR were measured at 24 h, 48 h, and 72 h after PCI. Research nurses collected data on handwritten forms, and then stored them in password-protected electronic databases. RESULTS The creatinine clearance rate and eGFR were increased, while the creatinine and cystatin C levels were decreased significantly in the rhBNP treatment group compared to the control group at 48 h and 72 h. The incidence of CIN ( P = 0.028) and acute heart failure ( P = 0.017) also significantly decreased in the rhBNP group. No significant difference was noted between the two groups in cardiac death and recurrent AMI. CONCLUSION Early application of rhBNP could protect renal function and decrease the incidence of CIN after primary PCI and acute heart failure.

Efficacy of recombinant human brain natriuretic peptide as an adjuvant therapy for severe heart failure, and its impact on oxidative stress and quality of life in patients

“…It mainly regulates hemodynamics by activating vascular endothelial protein kinase so as to promote vasodilation. Previous studies have proven that it is effective in treating myocardial infarction and other diseases [19,20].…”

The effects of prophylactic intravenous injection of rhBNP on prognosis in patients with STEMI undergoing PPCI

“…We believe that this may be due to rhBNP's ability to relieve peripheral circulation and cardiac load, increase coronary artery blood supply, promote the recovery of myocardial cell function, further increase myocardial contractility, and dilate blood vessels while treating, thereby improving the patient's overall condition. In addition, studies have shown that rhBNP can maintain vascular and renal hemodynamic balance by reducing the secretion of renin and aldosterone, an antagonizing antidiuretic hormone from the posterior pituitary gland, and preserving sodium in the sympathetic nerves (18), which is more conducive to the recovery of patients' hemodynamics.…”