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Statin therapy decreases N-terminal pro-B-type natriuretic peptide in HIV: randomized placebo-controlled trial.
Dirajlal-Fargo, S, Kinley, B, Jiang, Y, Longenecker, CT, Hileman, CO, Debanne, S, McComsey, GA
AIDS (London, England). 2015;(3):313-21
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Abstract
OBJECTIVE HIV-infected participants are at a higher risk for cardiovascular disease (CVD). N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a significant predictor of CVD in the general population and is associated with mortality in HIV. DESIGN AND METHODS The 96-week Stopping Atherosclerosis and Treating Unhealthy Bone with Rosuvastatin in HIV (SATURN-HIV) trial randomized 147 patients on stable antiretroviral therapy with low-density lipoprotein-cholesterol level lower than 130 mg/dl and without overt heart failure to 10 mg daily rosuvastatin or placebo. We measured NT-proBNP levels by enzyme-linked immunosorbent assay (ELISA). Baseline and changes in NT-proBNP were compared between groups. Spearman correlation was used to explore relationships between baseline NT-proBNP, inflammation, and CVD risk markers. Multivariable analyses were conducted to assess associations with NT-proBNP levels. RESULTS Median age was 46 years, 80% were men, 69% were African American, and 46% were on protease inhibitors. At baseline, median (Q1, Q3) NT-proBNP was higher in the rosuvastatin group than placebo [41 (20, 66.5) versus 25 pg/ml (11, 56), P = 0.012)]. Baseline NT-proBNP correlated with bulb and common carotid artery intima-media thickness, coronary calcium score, interleukin 6, and cystatin C. After 96 weeks, median NT-proBNP decreased significantly in the rosuvastatin group versus placebo (-1.50 versus +4.50 pg/ml, P = 0.041). Within the rosuvastatin group, changes in NT-proBNP were negatively correlated with changes in insulin resistance and total limb fat. CONCLUSION Rosuvastatin reduces plasma NT-proBNP in HIV-infected participants on antiretroviral therapy. NT-proBNP correlated with several measures of CVD risk, independent of inflammation markers.
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B-type natriuretic peptide for prevention of contrast-induced nephropathy in patients with heart failure undergoing primary percutaneous coronary intervention.
Zhang, J, Fu, X, Jia, X, Fan, X, Gu, X, Li, S, Wu, W, Fan, W, Su, J, Hao, G, et al
Acta radiologica (Stockholm, Sweden : 1987). 2010;(6):641-8
Abstract
BACKGROUND Contrast-induced nephropathy (CIN) is one of the leading causes of hospital-acquired renal failure and increase in the mortality and length of hospital stay after percutaneous coronary intervention (PCI). PURPOSE To evaluate the protective effect of B-type natriuretic peptide (BNP) on CIN in patients with heart failure undergoing PCI. MATERIAL AND METHODS In the prospective, placebo-controlled, randomized trial, 149 consecutive acute myocardial infarction (AMI) patients with heart failure undergoing primary PCI received recombinant human BNP (rhBNP) or placebo from the time of admission to 24 h after PCI. Serum creatinine (SCr) levels were measured to evaluate the protective effect of rhBNP on renal function. Estimated glomerular filtration rate (eGFR) was calculated by the simplified modification of diet in renal disease study equation. CIN was defined as a postprocedure peak increase in SCr of >0.5 mg/dl or >25% from baseline. RESULTS The baseline characteristics were similar in the two groups. The SCr significantly increased after PCI, with the peak value at 48 h, and then began to decrease. At day 7 after PCI, the SCr had lowered to the baseline level in the BNP group, but it failed to do so in the control group. At 24, 48, and 72 h and 7 days after PCI, the SCr was lower in the BNP group than that in the control group. The eGFR decreased significantly after PCI, with the lowest value at 48 h, and then it began to increase. The eGFR after PCI was higher in the rhBNP group than that in the control group. The occurrence of CIN was significantly lower in the rhBNP group than in the control group. CONCLUSION Periprocedural use of BNP could further promote the recovery of renal function and decrease the occurrence of CIN compared with routine treatment alone in patients with heart failure undergoing primary PCI.