Effect of rhBNP on CMD in Patients With STEMI After PPCI

Henan Institute of Cardiovascular Epidemiology

Status: Not yet enrolling

Conditions: STEMI

Treatments: Drug: recombinant human B-type natriuretic peptide

Study type: Interventional

Funder types: Other

Identifiers

NCT05723315

HenanICE202301

Details and patient eligibility

About

The target population of this interventional study was STEMI patients. Primary discussion: Early rhBNP reduces microcirculation obstruction in STEMI patients undergoing primary PCI

Full description

Direct percutaneous coronary intervention is the preferred reperfusion strategy for acute ST-segment elevation myocardial infarction. During the opening of infarct-related vessels, 5%-50% of patients showed slow flow or no reflow and other coronary microcirculation dysfunction, which aggravated myocardial injury and increased the incidence and mortality of heart failure. Studies have shown that recombinant human brain natriuretic peptide (rhBNP) can reduce reperfusion injury and reduce myocardial infarction area CMD. Prolonged ischemia leads to rapid depletion of intracellular ATP and tissue metabolic acidosis. Blood flow irrigation during reperfusion leads to decreased levels of ATP precursors, calcium overload in mitochondria, release of a large number of inflammatory factors and oxygen free radicals, which can lead to injury or death of myocardial and endothelial cells. rhBNP can enhance the activity of antioxidant enzymes, reduce the irreversible oxidative damage caused by free radicals to myocardium, reduce the myocardial infarction area during ischemia reperfusion, and may reduce the reperfusion injury and protect the viable myocardium.

Enrollment: 160 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• STEMI
• PPCI within 24 hours of symptom onset
• Target vessel QFR-MR>250mm Hg*s/m

Exclusion criteria

• claustrophobia
• Postoperative TIMI grade 0-1
• Pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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160 participants in 2 patient groups

Experimental Group 1

Experimental group

Description:

The experimental group was given neoptin within 3h after PCI for 72 hours (first at 1.5μg /kg intravenous load, then at 0.015μg /kg/min).

Treatment:

Drug: recombinant human B-type natriuretic peptide

Control Gruop

No Intervention group

Description:

The experimental group was given an intravenous infusion of the same amount of normal saline