Efficacy of continuous low-dose hANP administration in patients undergoing emergent coronary artery bypass grafting for acute coronary syndrome.
BACKGROUND
Low-dose continuous human atrial natriuretic peptide (hANP) administration during cardiac surgery has been reported on previously. In the present study, the efficacy of the therapy during emergent coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS) is investigated.


RESULTS
One hundred and twenty-four patients patients undergoing emergent CABG for ACS were divided into 2 groups; a group receiving administration of hANP (hANP group) and a group not receiving hANP infusion (non-hANP group). The postoperative peak levels of creatine kinase-MB were significantly lower in the hANP group as compared with those in the non-hANP group. The incidence of postoperative arrhythmias was also significantly lower in the hANP group as compared with that in the non-hANP group. The postoperative brain natriuretic peptide was significantly lower in the hANP group as compared with that in the non-hANP group until 1 year after the operation. The free-rate of cardiac events after the operation was also significantly higher in the hANP group as compared with that in the non-hANP group.


CONCLUSIONS
It is therefore considered that hANP might not only be effective for overcoming some major shortcomings of cardiopulmonary bypass, but also might be effective to attenuate ischemia-reperfusion injury, protect the myocardium, have an anti-arrhythmic effect, and suppress left ventricular remodeling.
Sezai
Akira
A
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. asezai@med.nihon-u.ac.jp
Hata
Mitsumasa
M
Wakui
Shinji
S
Niino
Tetsuya
T
Takayama
Tadateru
T
Hirayama
Atsushi
A
Saito
Satoshi
S
Minami
Kazutomo
K
D054058:Acute Coronary Syndrome / Q000097:blood / Q000601:surgery*; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000517:prevention & control*; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000517:prevention & control*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D020257:Ventricular Remodeling / Q000187:drug effects*
D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor