title: Effects of recombinant human brain natriuretic peptide on the prognosis of patients with acute anterior myocardial infarction undergoing primary percutaneous coronary intervention: a prospective, multi-center, randomized clinical trial.
abstract: BACKGROUND
  This study aims to investigate the effects of recombinant human brain natriuretic peptide (rhBNP) on serum enzyme data, cardiac function parameters and cardiovascular events in patients with acute anterior myocardial infarction (MI).
  
  
  METHODS
  A total of 421 patients with acute anterior or extensive anterior MI were collected from 20 hospitals. These patients were randomly divided into two groups: rhBNP and control groups. Both groups of patients received primary percutaneous coronary intervention (PCI) within the effective time window. In the rhBNP group, rhBNP administration (0.01 µg/kg/min, 48-72 successive hours) was performed as early as possible after hospital admission. Prior to and one or seven days after PCI, serum concentrations of cardiac troponin (cTnT), creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured. At seven days and 6 months after PCI, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd) and stroke volume (SV) were measured using 2D Doppler echocardiography. MACEs that occurred during hospitalization and within 6 months after PCI were recorded.
  
  
  RESULTS
  At postoperative days one and seven, serum concentrations of cTnT were significantly lower in the rhBNP group than in the control group. At postoperative day one, serum concentrations of CK-MB were significantly lower in the rhBNP group than in the control group. At postoperative day seven, serum concentrations of NT-proBNP were significantly lower in the rhBNP group than in the control group, and LVEF was significantly greater in the rhBNP group than in the control group. At postoperative 6 months, LVEDd was significantly lower in the rhBNP group compared with the control group. In addition, SV and LVEF were significantly greater in the rhBNP group than in the control group. By postoperative month 6, the incidence of composite cardiovascular events (16.0%vs. 26.0%, P=0.012), cardiac death (7.0%vs.13.5%, P=0.030), and particularly cardiac death + re-hospitalization for congestive heart failure (13.1%vs. 25.5%, P=0.001) were significantly lower in the rhBNP group than in the control group.
  
  
  CONCLUSIONS
  Early intravenous rhBNP administration after PCI significantly lowered the serum concentrations of cTnT and NT-proBNP, increased LVEDd, SV and LVEF, and reduced MACEs, including cardiac death, in patients with acute anterior MI undergoing PCI.
authors.affiliation: Department of Cardiology, The People's Hospital of China Medical University (The People's Hospital of Liaoning Province), Shenyang 110016, China.
authors.forename: Zhi-Lin
authors.initials: ZL
authors.lastname: Miao
authors.affiliation: Department of Cardiology, The People's Hospital of China Medical University (The People's Hospital of Liaoning Province), Shenyang 110016, China.
authors.forename: Ai-Jie
authors.initials: AJ
authors.lastname: Hou
authors.affiliation: Department of Cardiology, the 463rd Hospital of PLA, Shenyang 110042, China.
authors.forename: Hong-Yun
authors.initials: HY
authors.lastname: Zang
authors.affiliation: Department of Cardiology, Tieling Central Hospital, Tieling 112000, China.
authors.forename: Ru-Gang
authors.initials: RG
authors.lastname: Huang
authors.affiliation: Department of Cardiology, Dalian Municipal Central Hospital, Dalian 116013, China.
authors.forename: Xiao-Qun
authors.initials: XQ
authors.lastname: Zheng
authors.affiliation: Department of Cardiology, Dalian Municipal Central Hospital, Dalian 116013, China.
authors.forename: Hai-Long
authors.initials: HL
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Dandong Central Hospital, Dandong 118002, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Liaoning 110032, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Hou
authors.affiliation: Department of Cardiology, The People's Hospital of China Medical University (The People's Hospital of Liaoning Province), Shenyang 110016, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Xia
authors.affiliation: Department of Cardiology, The People's Hospital of China Medical University (The People's Hospital of Liaoning Province), Shenyang 110016, China.
authors.forename: Zhan-Quan
authors.initials: ZQ
authors.lastname: Li
keywords: Acute anterior myocardial infarction; N-terminal pro-brain natriuretic peptide (NT-proBNP); major adverse event; percutaneous coronary intervention (PCI); recombinant human brain natriuretic peptide