Randomized Controlled Trial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12221-12229
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12221
Protective effect of recombinant human brain natriuretic peptide against contrast-induced nephropathy in elderly acute myocardial infarction patients: A randomized controlled trial
Yi-Jing Zhang, Lin Yin, Jun Li
Yi-Jing Zhang, Lin Yin, Jun Li, Department of Imaging, 904th Hospital of Joint Logistic Support Force of PLA, Wuxi 214044, Jiangsu Province, China
Author contributions: Zhang YJ and Li J contributed equally to this work; Zhang YJ, Yin L, and Li J gave the conception and designed the research study; Zhang YJ performed the research; Zhang YJ, Yin L, and Li J analyzed the data; Zhang YJ, Yin L, and Li J wrote the manuscript; all authors gave their final approval and agree to be accountable for all aspects of the work.
Institutional review board statement: The study protocol was approved by the Anhui Medical University Affiliated Wuxi Clinical College Clinical Research Ethics Committee (Approval No. 2016-YXLL-051).
Clinical trial registration statement: This study was registered at Hospital Clinical Trial Registry (No. WXCTR-IM-171162).
Informed consent statement: Written informed consent was obtained from the patients whose competence was established by their accurate orientation for time, place, and person, as well as an understanding of the recruiter’s description of the trial or from their next of kin or legal representative.
Conflict-of-interest statement: The authors declare that there are no conflicting interests to disclose.
Data sharing statement: The corresponding author may provide the datasets used in the study upon request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Li, BSc, Chief Nurse, Department of Imaging, 904th Hospital of Joint Logistic Support Force of PLA, No. 101 Xing Yuan North Road, Wuxi 214044, Jiangsu Province, China. sm2008@21cn.com
Received: July 17, 2022
Peer-review started: July 17, 2022
First decision: September 9, 2022
Revised: September 21, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 26, 2022
ARTICLE HIGHLIGHTS
Research background

The overall incidence of contrast-induced nephropathy (CIN) is high after percutaneous coronary intervention (PCI), which leads to unfavorable early and long-term outcomes.

Research motivation

How to decrease the risk of CIN after PCI and explore clinical drugs to improve the outcome of elderly acute myocardial infarction (AMI) patients deserves further study.

Research objectives

To explore the clinical effectiveness of recombinant human brain natriuretic peptide (rhBNP) for CIN in elderly AMI patients after PCI.

Research methods

One hundred and thirty-one elderly AMI patients underwent PCI: The control group (n = 66) was given 1 mL of 0.9% normal saline/(kg/h) for 72 h after PCI and the rhBNP group (n = 65) received intravenous rhBNP [1.5 mg/kg followed by 0.0075 mg/(kg/min)] for 72 h. Serum creatinine and cystatin C levels, creatinine clearance rate, and eGFR were measured at 24 h, 48 h, and 72 h after PCI.

Research results

The creatinine clearance rate and eGFR were increased, while the creatinine and cystatin C levels were decreased significantly in the rhBNP group compared to the control group at 48 h and 72 h. The risk of CIN and acute heart failure also significantly decreased in the rhBNP group. We found no statistic difference between the two groups in cardiac death and recurrent AMI.

Research conclusions

Early application of rhBNP can protect the renal function and decrease the incidence of CIN in elderly AMI patients after primary PCI, reducing the incidence of acute heart failure.

Research perspectives

Our study suggests that early rhBNP treatment might help to protect renal function and decrease the incidence of CIN in elderly AMI patients after primary PCI, reducing the incidence of acute heart failure. Based on these results, rhBNP treatment can be widely promoted. Also, more research is required with patients who receive varied dosages to understand the prospective application of rhBNP in postoperative elderly patients.