Abstract 1888: Effects of Carperitide (hANP) Treatment on Long-term Prognosis in Patients with Acute Decompensated Heart Failure
Backgrounds; Carperitide (hANP) has been applied clinically for the management of acute decompensated heart failure (ADHF) by exertion of its unique pharmacological actions, vasodilating action to reduce both preload and afterload, natriuretic action, and RAAS inhibitory effects. However its effects on long-term prognosis has not been studied.
Methods and Results; Multi-center randomized controlled study (PROTECT: prospective trial of cardiopro-tective effect of carperitide treatment) was performed to clarify effects on long-term prognosis in ADHF. Forty-nine eligible patients (Carperitide [Car]; n=26 versus Control [Cont]; n=23) were studied. In Car group, low dose carperitide (0.01– 0.05 microgram/kg/min) was infused for 72 hours at the initial treatment. In Cont group, standard medical treatments were given without any limitation except for the use of Car and anti-aldosterone drugs. Significant increases in ANP (p<0.0001) and cyclic GMP levels (p=0.0384) during Car infusion were confirmed. However changes in blood BNP, troponin T, or creatinine levels did not show significant differences between the two groups. During 1.5year follow-up, significant reduction of mortality and re-hospitalization was observed (11.5% versus 34.8%, p=0.0359). Cox regression analysis revealed that no carperitide treatment (HR: 5.62, p=0.020), SBP (>140mmHg, HR: 0.27, p=0.043), and beta-blocker induction (HR: 0.15, p=0.016) were independent predictors for cardiac events.
Conclusion; Low dose carperitide treatment and beta-blocker induction lowered long-term mortality and rehospitalization in ADHF.