Effect of intravenous nitrate treatment on serum  BNP level and 30-day follow-up events in  decompensated systolic heart failure: Dekompanze sistolik kalp yetmezlikli hastalarda intravenöz  nitrat tedavisinin serum BNP seviyesi ve 30 günlük takip  olayları üzerine etkisi

Mustafa  Topuz; Mehmet  Kaplan

doi:10.5152/EurJTher.2017.207

Authors

Mustafa Topuz Clinic of Cardiology, University of Healthy Science Adana Numune Training and Research Hospital
Mehmet Kaplan Clinic of Cardiology, University of Healthy Science Adana Numune Training and Research Hospital, Adana

DOI:

https://doi.org/10.5152/EurJTher.2017.207

Keywords:

Intravenous nitrate, systolic heart failure, B-type natriuretic peptide

Abstract

Objective: The aim of this study was to evaluate the potential of intravenous (IV) nitroglycerine (NTG) administration to accelerate the reduction of B-type natriuretic peptide (BNP) levels in patients with decompensated systolic heart failure (HF) and to evaluate its impact on follow-up events.
Methods: A total of 165 patients with systolic HF who were hospitalized due to acute decompensation were enrolled into the current study. Study patients were divided into two groups. Patients who were receiving standard HF therapy (angiotensin-converting enzyme [ACE] or angiotensin receptor blocker [ARB], beta-blockers, loop diuretics, and anticoagulant or anti-aggregant agents for venous prophylaxis) were categorized as the standard HF therapy group (n=72), and patients receiving a standard dose of IV NTG in addition to standard HF therapy were categorized as the IV NTG group (n=93). BNP levels and blood gas analyses were measured at admission and after 48 h; all patients were followed up along the first month after discharge.
Results: Serum BNP levels decreased in all patients after 48 h. The decreasing of BNP level was higher and the improvement of blood gas analysis was better in the IV NTG group than in the standard therapy group (1347.1±314.3 vs. 280.0±196.2 pg/mL for the IV NTG group and 1178.3±305.5 vs. 495.4±229.9 pg/mL for the standard therapy group; p<0.001). In the multi-logistic regression analysis, serum sodium at admission, BNP level at 48 h, and use of IV NTG were found as predictors of 30-day follow-up events.
Conclusion: We have shown that IV NTG therapy in addition to standard HF therapy has a markedly better effect on lowering of plasma BNP levels, improves blood gas analyses, and may reduce follow-up events in patients with systolic HF.

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