Resumo

SHI, Dahuan et al. Benefits of recombinant human brain natriuretic peptide to improve ventricular function and hemodynamics in patients with ST-elevation myocardial infarction. Invest. clín [online]. 2024, vol.65, n.3, pp.335-345.  Epub 12-Set-2024. ISSN 0535-5133.  https://doi.org/10.54817/ic.v65n3a06.

This study aimed to assess the impact of recombinant human brain natriuretic peptide (rh-BNP) on ventricular function and hemodynamics in post-ST-segment elevation myocardial infarction (STEMI). We compared the outcomes of 65 STEMI patients treated with rh-BNP to an equal cohort given tirofiban following percutaneous coronary intervention (PCI). Data collected pre- and post-intervention included biochemical markers, TIMI (Thrombolysis In Myocardial Infarction) grade, hemodynamics, thrombotic score (TS), left ventricular ejection fraction (LVEF), high-sensitivity C-reactive protein (CRP) levels, liver and kidney function, and ECG. The TIMI level (p=0.03), the ratio of TIMI myocardial perfusion grade III (p=0.04), and the thrombus score (p<0.001) in the rh-BNP group after the intervention markedly exceeded those in the tirofiban group. After correction, the TIMI frame count (CTFC) (p=0.02), the incidence of slow flow (p=0.02), thrombus score (p<0.001), stent length (p=0.02) as well as times of administration of sodium nitroprusside medication in the rh-BNP group were markedly below those in the tirofiban group (p=0.01). Creatine kinase (CK) (p<0.001), CK-MB (p=0.01), and N-terminal pro-b-type natriuretic peptide (NT-proBNP) (p<0.02) in the rh-BNP group were markedly below those the in tirofiban group 24 hours after intervention; and the sum-STR (p<0.03) immediately after intervention markedly exceeded that in the tirofiban group. No significant differences were found in major cardiac adverse events (MACE) between the treatments. At the 30-day follow-up, rh-BNP showed a more effective enhancement of blood flow status, with the safety profiles of both treatments being comparable. The findings suggest that the rh-BNP has significant potential for treating PPCI-related slow flow.

Palavras-chave : ST-segment elevation myocardial infarction; recombinant human brain natriuretic peptide; tirofiban; primary percutaneous coronary intervention.

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