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《Chinese Journal of Critical Care Medicine》 2019-03
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Prognostic impact of cedilanid administration after early reperfusion 2 h on collagen metabolism in acute myocardial infarction complicated with acute heart failure patients

Huang Gan-hong;Liu Dong-hua;Xiao Jun-hui;Xu Zhi-qi;Li Li;Department Emergency Medicine,Guangzhou Huadu People's Hospital;  
Objective To observe the clinical efficacy and safety of cedilanid administration after early percutaneous coronary intervention(PCI) 2 h on left ventricular remodeling and collagen metabolism in acute myocardial infarction complicated with acute heart failure( AMI-AHF) patients.Methods A total of 93 AMI-AHF patients in our hospital from January 2017 to January 2018 were selected and randomly divided into observation group(Cedilanid 0. 2 mg + 0. 9% saline 20 mL, n =48) and control group(0. 9% saline 20 mL, n = 45). The hemodynamic parameters, such as pulmonary capillary wedge pressure( PCWP), cardiac index( CI) and stroke volume( SV) were monitored. The left ventricular ejection fraction( LVEF) and short axial shortening rate(FS) were measured by doppler echocardiography. The levels of plasma creatine kinase isoenzyme( CK-MB),myoglobin(Myo), cardiac troponin I(cTnI), B type natriuretic peptide(BNP), carboxy-terminal propeptide of type I collagen(PICP) and aminoterminal propeptide of type Ⅲ collagen(PⅢNP) were detected by kits. Results ①Changes of hemodynamic indicators: the indicators of CI, SV increased,PCWP declined after reperfusion, which were significantly obvious between the groups at different time(P0. 05). ②Changes of echocardiography indexes: the indicators of LVEF and FS increased after PCI. LVEF[(50.48 ±4.79)% and(954.08±5.12)%]and FS[(26.85 ±4.08)% and(28.45 ±3.97) % ] of observation group were obviously higher than control group at different times after medication of 3 h and 24 h( P 0.05).③Changes of plasma level: the levels of CK-MB,Myo,cTnI and BNP in both observation and control groups were lower than before administration at medication of 3 h and 24 h(P0.05). And the levels of Myo[(982.46 ±458.51) ng/mL] and BNP[(460.61 ±154.95) ng/mL] in observation group were a little higher than control group( P 0.05). ④Changes of collagen metabolism indexes: the levels of PI CP in both observation and control groups were higher than before administration at medication of 24 h(P 0. 05). And the levels of PI CP [(24. 57 ± 7. 34)ng/mL ] and PⅢ NP [(2.68 ±1.51) ng/mL ] in observation group were lower than control group(P 0.05). Conclusion Early application of cedilanid can improve the left ventricular systolic function and collagen metabolism, It is a safe and effective treatment for reperfused AMI-AHF patients.
【CateGory Index】: R542.22;R541.6
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