Brain natriuretic peptide for prevention of contrast-induced nephropathy after percutaneous coronary intervention or coronary angiography.

BACKGROUND: Many methods reportedly prevent contrast-induced nephropathy (CIN), but the effect of brain natriuretic peptide (BNP) on CIN is unknown. In this study we investigated recombinant BNP use before coronary angiography (CA) or nonemergent percutaneous coronary intervention (PCI) in patients with unstable angina. METHODS: One thousand patients with unstable angina were prospectively evaluated. The patients were randomly assigned to: group A, isotonic normal saline (NaCl 0.9%, 1 mL/kg/h) for 24 hours before CA or PCI; and group B, human recombinant BNP (rhBNP; 0.005 µg/kg/min). Serum creatinine (Scr) levels and estimated glomerular filtration rate were measured before and 24, 48, and 72 hours, and 7 days after the procedure. The primary outcome was CIN incidence defined according to a relative (≥ 25%) or absolute (≥ 0.5 mg/dL and 44 µmol/L, respectively) increase in Scr from baseline within 48 hours. The secondary end points were the changes in the Scr and estimated glomerular filtration rate, before and after the procedure. RESULTS: Contrast volume, a history of diabetes mellitus, and BNP administration independently predicted CIN. The incidence of CIN was significantly greater in group A than in group B (14.8% vs 5.6%; P < 0.01). Renal function was less compromised in patients who received rhBNP. The Scr of all patients with CIN remained increased for 24 hours, but it was lower and recovered faster in patients who received rhBNP. CONCLUSIONS: rhBNP administration before CA or PCI protects renal function and can significantly decrease CIN incidence.

Efficacy and tolerability of a single-pill combination of amlodipine/valsartan in Asian hypertensive patients not adequately controlled with valsartan monotherapy.

This randomized, double-blind study evaluated efficacy of a single-pill combination of amlodipine/valsartan (Aml/Val) in Asian patients with hypertension not responding to Val 80 mg. Patients with mean sitting diastolic blood pressure (DBP) ≥90-≤110 mmHg were randomized to Aml/Val 5/80, Val 80, or Val 160 mg for 8 weeks. At week-8 endpoint, significantly greater reductions in BP were seen with Aml/Val 5/80 mg than valsartan monotherapies (p < 0.0001). The BP control was greater with Aml/Val 5/80 (70.5%) than Val (44.1-58.6%) monotherapies. The combination was well tolerated. In conclusion, single-pill combination with Aml/Val provided significant additional BP reduction and control in hypertensive patients not responding to Val 80 mg.

[Clinical predictability of the waist-to-hip ratio in assessing the risk factors of cardiovascular disease among public servants in Shijiazhuang city].

OBJECTIVE: To assess the clinical predictability of waist-to-hip ratio (WHR) among female civil servants who had experienced risk factors of cardiovascular disease. METHODS: Data was gathered from 4153 female civil servants aged 21-91 y working at universities who were enrolled in health screening centre at the Second Hospital Attached to Hebei Medical University, in 2006. WHR quartiles were determined., as: < 0.80, 0.80- < 0.84, 0.84- < 0.90 and > or = 0.90. Subjects were placed into high-risk categories for cardiovascular disease on the basis of national health reference on range norms of protocol including hypertension, diabetes mellitus and dyslipidemia. RESULTS: Participants had an increased likelihood of hypertension (systolic blood pressure), dyslipidemia (elevated triacylglycerol and descending HDL-C) and diabetes mellitus at WHR > or = 0.84. All aforementioned variables had a significant odds ratio at WHR > or = 0.84. This trend was further persisted after adjustment had been made on smoking, age, and BMI. Descended HDL-C was observed at the 0.80 < or = WHR < 0.84 when compared with WHR < 0.80. CONCLUSION: These data indicated an upward shift in the critical threshold for WHR to > or = 0.84. Above which point, there was an elevation of risk factors on cardiovascular diseases among all the female civil servants. The trend persisted regardless of smoking, BMI < or > or = 28 and at what age group, among the civil servants population.