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Efficacy of continuous low-dose hANP administration in patients undergoing emergent coronary artery bypass grafting for acute coronary syndrome.

AbstractBACKGROUND:
Low-dose continuous human atrial natriuretic peptide (hANP) administration during cardiac surgery has been reported on previously. In the present study, the efficacy of the therapy during emergent coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS) is investigated.
METHODS AND RESULTS:
One hundred and twenty-four patients patients undergoing emergent CABG for ACS were divided into 2 groups; a group receiving administration of hANP (hANP group) and a group not receiving hANP infusion (non-hANP group). The postoperative peak levels of creatine kinase-MB were significantly lower in the hANP group as compared with those in the non-hANP group. The incidence of postoperative arrhythmias was also significantly lower in the hANP group as compared with that in the non-hANP group. The postoperative brain natriuretic peptide was significantly lower in the hANP group as compared with that in the non-hANP group until 1 year after the operation. The free-rate of cardiac events after the operation was also significantly higher in the hANP group as compared with that in the non-hANP group.
CONCLUSIONS:
It is therefore considered that hANP might not only be effective for overcoming some major shortcomings of cardiopulmonary bypass, but also might be effective to attenuate ischemia-reperfusion injury, protect the myocardium, have an anti-arrhythmic effect, and suppress left ventricular remodeling.
AuthorsAkira Sezai, Mitsumasa Hata, Shinji Wakui, Tetsuya Niino, Tadateru Takayama, Atsushi Hirayama, Satoshi Saito, Kazutomo Minami
JournalCirculation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 71 Issue 9 Pg. 1401-7 (Sep 2007) ISSN: 1346-9843 [Print] Japan
PMID17721018 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor
Topics
  • Acute Coronary Syndrome (blood, surgery)
  • Aged
  • Arrhythmias, Cardiac (blood, prevention & control)
  • Atrial Natriuretic Factor (administration & dosage)
  • Cardiopulmonary Bypass
  • Coronary Artery Bypass
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Reperfusion Injury (blood, prevention & control)
  • Natriuretic Peptide, Brain (blood)
  • Ventricular Remodeling (drug effects)

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