Effects of Carperitide on the Long-Term Prognosis of Patients With Acute Decompensated Chronic Heart Failure The PROTECT Multicenter Randomized Controlled Study

DOI Web Site PubMed 被引用文献33件 参考文献50件
  • Hata Noritake
    Department of Intensive Care Unit, Chiba-Hokusoh Hospital, Nippon Medical School
  • Seino Yoshihiko
    First Department of Internal Medicine, Nippon Medical School
  • Tsutamoto Takayoshi
    Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science
  • Hiramitsu Shinya
    Department of Internal Medicine, Fujita Health University School of Medicine
  • Kaneko Noboru
    Department of Cardiology and Pneumology, Dokkyo University School of Medicine
  • Yoshikawa Tsutomu
    Cardiopulmonary Division, Department of Medicine, Keio University School of Medicine
  • Yokoyama Hiroyuki
    Department of Cardiovascular Medicine, Shizuoka National Hospital
  • Tanaka Keiji
    Intensive and Coronary Care Unit, Nippon Medical School
  • Mizuno Kyoichi
    Department of Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School
  • Nejima Jun
    Department of Internal Medicine, Tsurumi University School of Dental Science
  • Kinoshita Masahiko
    Kusatsu General Hospital

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タイトル別名
  • The PROTECT Multicenter Randomized Controlled Study

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Background Carperitide is used to treat acute decompensated heart failure (ADHF), but its effects on long-term prognosis have not been studied. Methods and Results A multicenter randomized controlled study of 49 patients with ADHF was performed to clarify the drug's effects on long-term prognosis. Low-dose carperitide (0.01-0.05 μg · kg-1 ·min-1) was infused for 72h as the initial treatment (n=26), whereas in the control group (n=23), standard medical treatment other than carperitide was given without limitation. Anti-aldosterone drugs were prohibited in both groups. During carperitide infusion, significant increases of the atrial natriuretic peptide and cyclic GMP levels and a significant decrease in the heart-type fatty acid-binding protein/serum creatinine ratio were observed, suggesting inhibition of myocyte cell membrane damage. On the other hand, no significant differences in the plasma brain natriuretic peptide, troponin T, and creatinine levels were noted in either group. During 18-month follow-up, significant reductions of death and rehospitalization occurred in the carperitide vs control group (11.5% vs 34.8%; p=0.0359). Cox regression analysis revealed that randomization to carperitide (p=0.020), pretreatment systolic blood pressure ≥140 mmHg (p=0.043), and β-blocker therapy (p=0.016) were independent predictors for freedom from cardiac events. Conclusions Acute-phase low-dose carperitide infusion improved the long-term prognosis of patients with ADHF. (Circ J 2008; 72: 1787 - 1793)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 72 (11), 1787-1793, 2008

    一般社団法人 日本循環器学会

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