Document Detail


Low-dose nesiritide improves renal function in heart failure patients following acute myocardial infarction.
MedLine Citation:
PMID:  20339970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was designed to investigate the effect of low-dose nesiritide on renal function and major cardiac events in patients with acute decompensated heart failure following acute myocardial infarction. Sixty patients were randomized into nesiritide (loading dose 0.5 microg/kg, maintenance dose 0.0075 microg/kg/min) and nitroprusside groups. Compared with the nitroprusside group, the nesiritide group had a greater heart rate reduction (P < 0.05), higher 24 h urine volume (P < 0.001), and more significant alleviation in dyspnea (P < 0.001). The prevalence of hypotension in the nesiritide group was lower than in the nitroprusside group (7.4% vs 28.5%, P < 0.05). The nesiritide group had a greater reduction in serum noradrenaline, angiotensin II, aldosterone, endothelin, and N-terminal prohormone brain natriuretic peptide (all P < 0.01). The mean serum creatinine in the nesiritide group was reduced (109.4 +/- 26.6 vs 102.8 +/- 21.6 micromol/l, P < 0.01), whereas it remained unchanged in the nitroprusside group (106.8 +/- 20 vs 106.0 +/- 19.2 micromol/l, P > 0.05). The rehospitalization or mortality rate was similar between the two groups 3 months after the therapy (P > 0.05). We conclude that low-dose nesiritide is more effective in suppressing the activation of the sympathetic and renin-angiotensin systems. It also improves the clinical symptoms and enhances renal function, but its effect on hospital readmission or mortality rate needs further investigation.
Authors:
Qiang Zhao; Tong-Guo Wu; Yi Lin; Biao Li; Jing-Yun Luo; Le-Xin Wang
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-03-26
Journal Detail:
Title:  Heart and vessels     Volume:  25     ISSN:  1615-2573     ISO Abbreviation:  Heart Vessels     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-26     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  97-103     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Red Cross Hospital of Guangzhou City, 510220, Guangzhou, Guangdong Province, PR China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Cardiovascular Agents / administration & dosage*,  adverse effects
Chi-Square Distribution
Creatinine / blood
Female
Heart Failure / drug therapy*,  etiology,  mortality,  physiopathology
Hemodynamics / drug effects
Humans
Kidney / drug effects*,  physiopathology
Kidney Diseases / drug therapy*,  etiology,  mortality,  physiopathology
Male
Middle Aged
Myocardial Infarction / complications,  drug therapy*,  mortality,  physiopathology
Natriuretic Peptide, Brain / administration & dosage*,  adverse effects,  blood
Nitroprusside / administration & dosage*,  adverse effects
Patient Readmission
Peptide Fragments / blood
Stroke Volume / drug effects
Time Factors
Treatment Outcome
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cardiovascular Agents; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 15078-28-1/Nitroprusside; 60-27-5/Creatinine

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