A meta-analysis of the clinical efficacy of rhBNP in treating patients with acute myocardial infarction and heart failure

Objective: To explore the clinical efficacy of rhBNP in patients with acute myocardial infarction (AMI) and heart failure (HF). Methods: A systematic review and a meta-analysis were performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. On May 30, 2020, we consulted the electronic databases PubMed, EBSCO, Elsevier, Springer, Wiley, and Cochrane using the keywords "acute coronary syndrome (ACS)", "brain natriuretic peptide (BNP)", and "acute myocardial infarction (AMI)". The quality of the data included in the study was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. The results of the clinical randomized controlled study reports were analyzed using Review Manager 5.1.0. Results: A total of nine, clinical, randomized, controlled studies were included. The effective rate in the rhBNP group was significantly higher than it was in the control group (Z = 9.50, P < 0.00001). The patients in the rhBNP group showed remarkably shorter hospital stays (Z = 24.43, P < 0.00001) and markedly increased left ventricular ejection fractions (LVEF) (Z = 245.53, P < 0.00001). Compared with the LVEF in the control group, the LVEF in the rhBNP group was significantly increased (Z = 3.55, P = 0.0004), but the rate of cardiac hypotension (Z = 3.55, P = 0.0004) and the headache incidence rate in the rhBNP group (Z = 2.3, P = 0.04) were not elevated. The rhBNP group showed no increase in either the low heart rate (Z = 1.22, P = 0.22) or the rate of renal insufficiency (Z = 0.35, P = 0.73). Conclusion: The meta-analysis suggests that, compared with the conventional treatment of patients with AMI and HF, rhBNP can markedly improve the clinical efficacy and myocardial functions and shorten the hospital stays, without elevating the rate of adverse reactions, such as hypotension, headaches, low heart rate, and renal insufficiency.