Results of Low-Dose Human Atrial Natriuretic Peptide Infusion in Nondialysis Patients With Chronic Kidney Disease Undergoing Coronary Artery Bypass Grafting

Sezai, Akira; Hata, Mitsumasa; Niino, Tetsuya; Yoshitake, Isamu; Unosawa, Satoshi; Wakui, Shinji; Kimura, Haruka; Shiono, Motomi; Takayama, Tadateru; Hirayama, Atsushi

doi:10.1016/j.jacc.2011.03.056

Cited by 102 publications

(79 citation statements)

References 21 publications

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“…Because hANP inhibits the renin-angiotensin-aldsterone system and has a potent natriuretic effect, we have found that it can compensate for the adverse effects of cardiopulmonary bypass and can inhibit reperfusion injury, left ventricular remodeling, postoperative arrhythmia and renal dysfunction. [11][12][13][14][15][16] In an experiment study, cyclic guanosine monophosphate was increased by the administration of hANP, and myocardial protective effects were reported. 17,18) Recently, continuous intravenous administration of hANP or BNP have been performed in cardiac surgery worldwide, its cardiac and reno-protective effects have been reported.…”

Section: Discussionmentioning

confidence: 99%

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Sezai¹,

Hata²,

Yoshitake³

et al. 2012

Ann Thorac Cardiovasc Surg

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Background: The results of emergency coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) are less than satisfactory, and readmission for cardiac events is common. Methods and Results: 105 patients underwent emergency CABG for AMI. We examined the long-term results of emergency CABG for AMI from the viewpoints of preoperative, intraoperative, and postoperative factors. The operative mortality rate was 11.4%. Risk factors for early death were age ≥80 years, shock, veno-arterial bypass, creatine kinase isoenzyme Mb ≥100 U/L, non-use of a left internal thoracic artery graft and an extracorporeal circulation time ≥120 min. Risk factors for late cardiac events were ejection fraction <40%, non-use of human atrial natriuretic peptide (hANP) therapy, angiotensin II receptor blockers (ARB) and aldosterone blockers, and a 3-month postoperative brain natriuretic peptide level ≥200 pg/ml. Conclusions: Early results of this study are similar to those seen in previous reports, whereas late phase results yield some new and interesting findings. We suggest that intraoperative hANP, and postoperative aldosterone blocker and ARB, following CABG for AMI, will, through control of the renin-angiotensin-aldsterone system, inhibit left ventricular remodelling, reduce the extent of infarction, and improve cardiac function, yielding a favourable long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Sezai¹,

Hata²,

Yoshitake³

et al. 2012

Ann Thorac Cardiovasc Surg

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“…In addition, appropriate perioperative medical therapy should be provided to reduce postoperative complications related to cardiopulmonary bypass and other complications such as cerebral infarction and renal failure. [15][16][17] …”

Section: Discussionmentioning

confidence: 99%

Early and Long-Term Outcomes in Japanese Patients Aged 80 Years or Older Undergoing Conventional Aortic Valve Replacement

Sezai

Osaka

Yaoita

et al. 2015

ATCS

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In this study, we investigated the early and long-term results of conventional aortic valve replacement (AVR) in very old patients. Methods: Seventy-five patients with aortic stenosis underwent conventional AVR for patients aged 80 years.We examined early death and major adverse cardiovascular and cerebrovascular event (MACCE). Results: The operative mortality was 0% for isolated AVR and 19.2% for concomitant surgery. The postoperative survival rate and MACCE free-rate were no significant differences between the isolated AVR and the concomitant surgery. Univariate analysis confirmed that cardiac dysfunction, severe chronic kidney disease (CKD), hemodialysis, + coronary artery bypass grafting, and norepinephrine use were risk factor of early death. Univariate analysis confirmed that severe CKD, BNP >1000 pg/ml, aortic cross clamping time (ACCT) >180 min, and non-use carperitide and multivariate analysis confirmed that ACCT >180 min, and non-use carperitide were risk factor of MACCE. Conclusions: This study showed that the results of conventional AVR in very old patients were not satisfactory. However, the results obtained with isolated AVR were favorable with no operative deaths. The present study demonstrated that preoperative cardiac function, preoperative renal function, and operative factors have an important impact on early mortality and MACCE.

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“…For renoprotective purpose, human atrial natriuretic polypeptide (Carperitide) is administered continuously in most cases, irrespective of preoperative renal function. 10) If excessive hemodilution was observed, intraoperative modified ultrafiltration was liberally done. 11) Choice of repair procedure or replacement was decided based on surgeon's preference.…”

Section: Methodsmentioning

confidence: 99%

Preoperative Estimated Glomerular Filtration Rate is an Independent Predictor of Late Cardiovascular Morbidity after Mitral Valve Surgery

Nakazato

Nakamura

Sekiya

et al. 2014

ATCS

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Results of Low-Dose Human Atrial Natriuretic Peptide Infusion in Nondialysis Patients With Chronic Kidney Disease Undergoing Coronary Artery Bypass Grafting

Cited by 102 publications

References 21 publications

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Early and Long-Term Outcomes in Japanese Patients Aged 80 Years or Older Undergoing Conventional Aortic Valve Replacement

Preoperative Estimated Glomerular Filtration Rate is an Independent Predictor of Late Cardiovascular Morbidity after Mitral Valve Surgery

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