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【medical-news】心肌梗死急性期使用心房利钠肽的
26October2007
MedWire News: Patients given atrial natriuretic peptide (ANP) after myocardial infarction (MI) have a smaller infarct size, fewer reperfusion injuries, and improved left ventricular ejection fraction (LVEF) than MI patients who do not receive this treatment, results from two trials indicate.
"We believe that ANP could be a safe and effective adjunctive treatment in patients with acute MI who receive percutaneous coronary intervention," the authors write in The Lancet.
Masafumi Kitakaze (National Cardiovascular Center, Suita, Osaka, Japan) and colleagues conducted two randomized trials to compare the effect of ANP or nicorandil with placebo in 1216 patients who had suffered acute MI and were undergoing reperfusion treatment.
In the ANP trial, 277 patients received intravenous ANP, at a dose of 0.025 µg/kg per min for 3 days, and 292 received the same dose of placebo. In the nicorandil trial, 276 patients were treated with 0.067 mg/kg as a bolus, followed by 1.67 µg/kg per min as a 24-hour continuous infusion, and 269 received the same dose of placebo.
Primary endpoints were infarct size, as estimated from creatine kinase levels, and LVEF, determined by angiography of the left ventricle.
The median follow-up was 2.7 and 2.5 years in the ANP and nicorandil trials, respectively,
Patients given ANP had significantly lower levels of creatine kinase than those in the placebo group (66,459.9 vs 77,878.9 IU/ml per hour), which indicated a 14.7% reduction in infarct size.
Patients in the ANP group had fewer reperfusion injuries than those in the placebo group (hazard ratio[HR]=0.74, p=0.01). Cardiac death and readmission to hospital for heart failure were also less likely in patients given ANP than in controls (HR=0.26, p=0.01).
Intravenous nicorandil did not significantly affect creatine kinase levels, LVEF, reperfusion injuries, cardiac death, or readmission to hospital for heart failure, compared with placebo.
However, oral administration of nicorandil during follow-up increased the LVEF between the chronic phase, at 2-8 weeks, and acute phase, at 6-12 months.
Kitakaze et al conclude: "Our finding that treatment with ANP in the acute phase reduced the incidence of readmission to hospital for chronic heart failure could help to reduce the physical, medical, and economic burdens on people around the world."
Richard Bogle and Martin Wilkins, from Imperial College London in the UK, write in an accompanying comment that as the studies were single-blind, "use of ANP as a treatment for acute MI needs further investigation in a double-blind study."
Lancet 2007; 370: 1483-1493 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Better outcomes for patients treated with ANP after MI
心肌梗死急性期使用心房利钠肽的患者预后更好
26October2007
2007,10,26
MedWire News: Patients given atrial natriuretic peptide (ANP) after myocardial infarction (MI) have a smaller infarct size, fewer reperfusion injuries, and improved left ventricular ejection fraction (LVEF) than MI patients who do not receive this treatment, results from two trials indicate.
MedWire消息：两个试验显示，MI后接受心房利钠肽（ANP）治疗的患者与未接受ANP治疗的患者相比，梗死面积更小，再灌注损伤更少，LVEF有所改善。
"We believe that ANP could be a safe and effective adjunctive treatment in patients with acute MI who receive percutaneous coronary intervention," the authors write in The Lancet.
作者在Lance上写到“我们认为ANP是急性心梗接受PCI患者的安全有效的辅助治疗。”
Masafumi Kitakaze (National Cardiovascular Center, Suita, Osaka, Japan) and colleagues conducted two randomized trials to compare the effect of ANP or nicorandil with placebo in 1216 patients who had suffered acute MI and were undergoing reperfusion treatment.
Masafumi Kitakaze（日本，大阪，Suita，国家心血管中心）及其同事做了两个随机实验，在1216例AMI接受再灌注治疗的患者中，比较ANP或尼可地尔与安慰剂的效果。
In the ANP trial, 277 patients received intravenous ANP, at a dose of 0.025 µg/kg per min for 3 days, and 292 received the same dose of placebo. In the nicorandil trial, 276 patients were treated with 0.067 mg/kg as a bolus, followed by 1.67 µg/kg per min as a 24-hour continuous infusion, and 269 received the same dose of placebo.
在ANP试验中，277例患者接受静脉注射ANP治疗，给予每分0.025 µg/kg，持续3 天；292例患者接受相同剂量的安慰剂治疗。在尼可地尔试验中，276例患者给予快速推注0.067 mg/kg后，每分1.67µg/kg，24小时连续输注；269例患者接受相同剂量的安慰剂治疗。
Primary endpoints were infarct size, as estimated from creatine kinase levels, and LVEF, determined by angiography of the left ventricle.
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作者:admin@医学,生命科学 2011-05-05 16:58
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