Effect Of Recombinant Human Brain Natriuretic Peptide On Coronary Blood Flow And Myocardial Perfusion In Patients With Acute Anterior Myocardial Infarction

objective: To observe the effect of recombinant human brain natriuretic peptide on coronary blood flow and myocardial perfusion after emergency in patients with acute anterior myocardial infarction.Methods: From September 2016 to June 2018,258 patients(164 males and 94 females)who were admitted to People’s Hospital of Liaoning Province for acute myocardial infarction,with an average age of(59.3±10.5)years,were randomly divided into recombinants.Brain natriuretic peptide(rhBNP)group(130 cases)and control group(128 cases).All patients signed a written informed consent form.The two groups of patients received conventional antiplatelet aggregation before PCI,and were given a loading dose of 300 mg of aspirin,300-600 mg of clopidogrel hydrogen sulfate,and 40 mg of atorvastatin calcium tablets to stabilize the plaque.Both groups of patients underwent surgery according to the standard coronary angiography within the effective time window,and two non-surgical physicians in the catheterization room of our hospital applied the same computer imaging statistical system to evaluate the TIMI blood flow grading of infarct-related arteries.In the case of corrected TIMI frame counts,TIMI blood flow grading in this study was used to describe coronary blood flow in patients with acute myocardial infarction immediately after PCI,and the corrected TIMI frame number was used as a simple and objective continuous variable indicator.Can better reflect the perfusion of myocardial tissue.The rhBNP group should be treated with recombinant human brain natriuretic peptide as soon as possible before PCI.Both groups of patients were routinely treated with basal drugs after PCI,including beta blockers,lipid-lowering plaques,angiotensin-converting enzyme inhibitors(ACEI)or angiotensin receptor blockers(ARB),Spironolactone,baseline data(age,sex,weight,hypertension,diabetes,hyperlipidemia,smoking)were recorded in both groups.TIMI blood flow grading and corrected TIMI frames in patients after infarction-related arterial access immediately after PCI;The levels of cTnT,CK-MB and NT-proBNP were measured 7 days after surgery;the left ventricular ejection fraction(LVEF)was measured by echocardiography at 1 week and 6 months after surgery;the two groups occurred during the 6-month period.Major adverse cardiovascular events(MACE).By comparing the TIMI blood flow grading and the corrected TIMI frame number between the two groups,we further explored the effects of recombinant human brain natriuretic peptide on coronary flow and myocardial perfusion in patients with acute anterior myocardial infarction after emergency PCI.influences.To evaluate the efficacy and safety of recombinant human brain natriuretic peptide in patients with acute anterior myocardial infarction after PCI by comparing myocardial enzymology changes,left ventricular ejection fraction and major adverse cardiovascular events after PCI in both groups.The results of the two groups of patients were statistically analyzed using SPSS 21.0 statistical software.p< 0.05 was considered statistically significant.Results: 1.Baseline data of the two groups: age,gender,weight,hypertension,diabetes,hyperlipidemia,smoking,no significant difference(p> 0.05);The drugs commonly used in the two groups included: β-blockers,lipid-lowering stable plaques,angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists,and spironolactones were not statistically different(p>0.05).2.The rate of TIMI3 blood flow in the rhBNP group after PCI was higher than that in the control group(96.2% vs 85.9%.p= 0.004),and the number of corrected TIMI blood flow frames in the rhBNP group was significantly lower than that in the control group(21.3 ± 7.8 vs 28.5 ± 14.3,p = 0.001).3.The cTnT and NT-proBNP in the rhBNP group were lower than those in thecontrolgroup(673.54±281.37pg/mlvs.796.44±316.86pg/ml,p<0.001;954.42±461.32 p g/ml.vs7 daysafter.1374.62±602.17pg/ml,p=0.001);ck-mb test results at 7 days postoperatively showed no statistically significant(p>0.05);4.The left ventricular ejection fraction of patients in the recombinant human brain natriuretic peptide group(45.81±4.78 vs 44.54±4.52,p=0.02.46.51±5.92 vs 43.47±5.63,p=0.001).5.Composite cardiovascular events in the rhBNP group during the 6-month follow-up period(16.9% vs 29.7%,p=0.018),cardiac death(8.5% vs 17.9%,p=0.028 The rate of re-hospitalization of heart failure was significantly lower than that of the control group(7.7% vs 17.2%,p=0.024).Conclusion: For patients with acute anterior myocardial infarction after emergency PCI,early application of recombinant human brain natriuretic peptide can significantly reduce serum cTnT and NT-proBNP levels,increase left ventricular ejection fraction,and reduce major adverse cardiovascular events,improve coronary flow and myocardial perfusion levels in patients.