title: Modulation of novel cardiorenal and inflammatory biomarkers by intravenous nitroglycerin and nesiritide in acute decompensated heart failure: an exploratory study.
abstract: BACKGROUND
  Modulation of novel cardiorenal and inflammatory markers may provide insight into the disease process and outcomes of patients with acute decompensated heart failure.
  
  
  RESULTS
  In this open-labeled, prospective, randomized study, 89 patients received either nesiritide (NES) or nitroglycerin (NTG) infusion by standard protocol. The serum or plasma concentrations of cystatin-C and inflammatory markers (high-sensitivity C-reactive protein, tumor necrosis factor-α, transforming growth factor-β1, and interleukin-6) were measured in 66 patients with acute decompensated heart failure at baseline and during drug infusion. Mean baseline values for demographics were not significantly different between NTG and NES groups; however, baseline inflammatory markers were elevated on admission. In NES compared with NTG groups, lower cystatin-C (1449 versus 2739 ng/mL, P<0.05) and IL-6 (25 versus 50 pg/mL, P<0.05) were observed. There were no significant differences in concentrations of high-sensitivity C-reactive protein, tumor necrosis factor-α, and transforming growth factor-β1 between groups over time.
  
  
  CONCLUSIONS
  The differential modulation effects of cystatin-C and interleukin-6 but not other inflammatory markers, in response to NES compared with NTG therapy, may provide important implications for vasodilator therapy. Further studies are warranted to confirm these findings.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00842023.
authors.affiliation: College of Pharmacy, Western University of Health Sciences, Pomona, CA 91766, USA. SChow@westernu.edu
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Chow
authors.forename: Stephen A
authors.initials: SA
authors.lastname: O'Barr
authors.forename: Jessica
authors.initials: J
authors.lastname: Peng
authors.forename: Eric
authors.initials: E
authors.lastname: Chew
authors.forename: Firooz
authors.initials: F
authors.lastname: Pak
authors.forename: Ryan
authors.initials: R
authors.lastname: Quist
authors.forename: Paryus
authors.initials: P
authors.lastname: Patel
authors.forename: J Herbert
authors.initials: JH
authors.lastname: Patterson
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Heywood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000097:blood*; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D045283:Natriuretic Agents / Q000494:pharmacology / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000494:pharmacology / Q000627:therapeutic use*; D005996:Nitroglycerin / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D012189:Retrospective Studies; D053773:Transforming Growth Factor beta1 / Q000097:blood; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D015850:Interleukin-6; D045283:Natriuretic Agents; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D005996:Nitroglycerin