Effect of rhBNP on CMD in Patients With STEMI After PPCI

Not Applicable

Not yet recruiting

• Conditions: STEMI
• Interventions: Drug: recombinant human B-type natriuretic peptide

• Registration Number: NCT05723315
• Lead Sponsor: Henan Institute of Cardiovascular Epidemiology

Brief Summary

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

Detailed 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.

Study Timeline

• Status Verified: 2023-02
• Study First Submitted: 2023-02-01
• Study First Submitted QC: 2023-02-01
• Last Update Submitted: 2023-02-01
• Study First Posted: 2023-02-10
• Last Update Posted: 2023-02-10
• Study Start: 2023-02-20
• Primary Completion: 2024-12-20
• Study Completion: 2025-12-20

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 160

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Experimental Group 1	recombinant human B-type natriuretic peptide	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).

Primary Outcome Measures

Name	Time	Method
MVO/LV(%)	3-14 days after PPCI	Microvascular obstruction assessed by magnetic resonance imaging

Secondary Outcome Measures

Name	Time	Method
MVO/LV(%)	30±7 days after PPCI	Microvascular obstruction assessed by magnetic resonance imaging
MACCEs	7days，30days，3months，6 months	Major Adverse Cardiac and Cerebrovascular event：Death, nonfatal myocardial infarction, heart failure, revascularization, stroke
LVEDV(ml)	3-14 days and 90±7 days after PPCI	Assessed by magnetic resonance imaging
Troponin (highest value)	3-14 days after PPCI	Troponin (highest value)
LGE/LV(%)	3-14 days and 90±7 days after PPCI	Cardiac magnetic resonance imaging
IMH	3-14 days after PPCI	Intramuscular hemorrhageCardiac assessed by magnetic resonance imaging
LVESV(ml)	3-14 days and 90±7 days after PPCI	Assessed by magnetic resonance imaging