Beneficial effects of early administration of recombinant human B-type natriuretic peptide in ST-elevation myocardial infarction patients receiving percutaneous coronary intervention treatment

Abstract

Introduction: We aimed to evaluate the clinical performance of early administration of recombinant human B-type natriuretic peptide (rhBNP) to ST-elevation myocardial infarction (STEMI) patients receiving percutaneous coronary intervention (PCI) treatment.

Methods: In total, 185 patients diagnosed with STEMI were enrolled and randomised into either the placebo-treated (n = 88) or rhBNP-treated (n = 97) group. Patients were given either saline or rhBNP ten minutes before PCI and monitored with various cardiac parameters, including accelerated idioventricular rhythm, frequent ventricular premature beat (FVPB), ventricular tachycardia, systolic blood pressure, thrombolysis in myocardial infarction (TIMI) 3 gradation, corrected TIMI frame count (cTFC) and myocardial blush grade (MBG) 3 classification.

Results: Our results revealed no difference in accelerated idioventricular rhythm between the two groups. However, FVPB and ventricular tachycardia were significantly decreased in rhBNP-treated patients compared to placebo-treated patients (p < 0.05). Moreover, the occurrence ratio of reperfusion-associated low blood pressure in rhBNP-treated patients was lower than in placebo-treated patients (p = 0.03), while no difference was observed in infarction-related arteries TIMI 3 blood flow between the two groups (p = 0.23). Importantly, measurement of post-reperfusion blood flow velocity via cTFC suggested that rhBNP treatment could significantly increase blood circulation (p = 0.003). After stent implantation, the acquisition rate of MBG 3 was higher in rhBNP-treated patients compared to placebo-treated patients (p = 0.071), although the difference was not significant.

Conclusion: We concluded that early administration of rhBNP can ameliorate the severity of reperfusion injury for STEMI patients receiving PCI treatment.

Keywords: anterior wall myocardial infarction; coronary blood flow; reperfusion injury; rhBNP.

Fig. 1

Bar graphs show the comparison of (a) accelerated idioventricular rhythm; (b) frequent ventricular premature beat; and (c) ventricular tachycardia between the placebo-treated and rhBNP-treated groups. *p < 0.05; NS: not significant; rhBNP: recombinant human B-type natriuretic peptide

Fig. 2

Bar graphs show the comparison of (a) SBP ≥ 90 mmHg; (b) 60 ≤ SBP < 90 mmHg between the placebo-treated and rhBNP-treated groups. *p < 0.05 is considered significant. NS: not significant; rhBNP: recombinant human B-type natriuretic peptide; SBP: systolic blood pressure

Fig. 3

Bar graphs show the comparison of (a) TIMI grade 3; (b) corrected TIMI frame count; and (c) myocardial blush grade 3 between the placebo-treated and rhBNP-treated groups. *p < 0.05; NS: not significant; rhBNP: recombinant human B-type natriuretic peptide; TIMI: thrombolysis in myocardial infarction