The Efficacy Of Early Initiation Of Recombinant Human Brain Natriuretic Peptide For The Prevention Of Heart Failure In Patients With Acute Anterior Myocardial Infarction

Objective To evaluate the efficacy of early initiation of recombinant human brain natriuretic peptide(rh BNP) for the prevention of heart failure(HF) in patients with anterior myocardial infarction.Methods 60 patients with acute anterior myocardial infarction were consecutively enrolled into this study from September 2011 to September 2013. The rh BNP group immediately infused rh BNP on the basis of conventional therapy when percutaneous coronary intervention or hospitalization. and the control group was selected 60 patients to match the baseline data of rh BNP group. All patients were classefied as Killip I, we reaorded baseline data and followed up for the change of NT-pro BNP concentrations, the new-onset HF and the adverse events during hospitalization. We used the logistic regression analysis to evaluation the independent factors of the new-onset HF. The adverse cardiac events(rehospitalization due to heart failure and all cause mortality) were evaluated 1 year after discharge.Results Baseline characteristics, drugs and peak cardiac biomarkers of myocardial damage were similar between the two groups. In control group, the peak NT-pro BNP concentrations was significantly increased compared with the rh BNP group(p=0.013) and 23 cases(38.3%) developed new-onset HF during hospitalization, while only 11 cases were in control group(18.3%)(p=0.026).we see LVEF, the peak NT-pro BNP and rh BNP were the independent factors. Adverse events including symptomatic hypotension, worsening of renal function, ventricular arrhythmias and atrial fibrillation in both groups were not significantly different. During an average of 328 days follow-up, 3(2.5%) patients died and 29(24.2%) patients were readmitted for HF. The incidence of cardiovascular composite endpoint events(all-cause mortality and rehospitalization for heart failure) had a lower trend in the rh BNP group, compared with the control group but not significantly in statistics(30.7% vs. 39.3%,respectively;P=0.45) Conclusion Early initiation of rh BNP forpatients with acute anterior myocardial infarction can prevent new-onset heart failure during hospitalization.