Abstract 3381: Usefulness of Carperitide as an Adjunctive Therapy for Acute Myocardial Infarction in Patients with Chronic Kidney Disease -Subgroup Analysis of J-WIND-ANP trial

Abstract

Background Chronic kidney disease (CKD) is highly prevalent in patients with cardiovascular disease. Recent investigation suggests that nesiritide (human brain natriuretic peptide) increases the risk of worsening renal function in patients with acute heart failure, whereas carperitide (human atrial natriuretic peptide) has beneficial effects on renal function. Methods We evaluated the usefulness of carperitide as an adjunctive therapy for acute myocardial infarction (AMI) in 158 patients with low eGRF (<60ml/min) estimated by the modified MDRD equation in J-WIND-ANP trial. Of 158 patients, 78 received carperitide (67±9 years old, male 54 patients) and 80 received placebo (67±9 years old, male 54 patients). Other risk factors such as hypertension, diabetes mellitus, and smoking were comparable between two groups. There was no difference in elapsed time between carperitide group (3.6hr 95%CI 3.0hr–5.9hr) and placebo group (3.5hr 95%CI 2.5hr-5.5hr). We analyzed the effects of carperitide on AUC of CK, ejection fraction (EF) at 6 months, and cardiac events. Results Carperitide administration reduced AUC of CK compared with placebo (carperitide group 65,040 mg/dl vs placebo group 79,286 mg/dl, p<0.05). Carperitide increased EF at 6 months after the onset of AMI compared with placebo (carperitide group 48.1±7.6% vs placebo group 44.0±10.0%, p<0.05). We found no significant difference in total death, cardiac events and reperfusion injury between both groups. Conclusions Carperitide reduced infarct size and improved chronic left ventricular function in AMI patients with CKD. These results suggest that carperitide is useful as an adjunctive therapy for AMI in AMI patients with CKD.