Effect of Recombinant Human Brain Natriuretic Peptide Combined with Irbesartan on Patients with Myocardial Infarction After PCI and the Effects on HCY, IMA and Lp-PLA2

OBJECTIVE To observe the effect of recombinant human brain natriuretic peptide(rhBNP) combined with irbesartan on acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI) and its effect on homocysteine(Hcy), ischemia modified albumin(IMA) and 2 lipoprotein-associated phospholipase A2(Lp-PLA2). METHODS The 150 patients with AMI and PCI who were admitted from January 2015 to December 2017 were randomly divided into observation group (75 cases) and control group (75 cases). The control group received conventional drug treatment and intravenous injection of rhBNP for 72 h; the observation group was given oral irbesartan 150 mg·d^-1 based on observation group. The clinical efficacy of the two groups was observed. The changes of myocardial enzymology, cardiac function, vascular endothelial function and adverse reactions were observed. The changes of HCY, IMA and Lp-PLA2 were observed in the two groups. RESULTS The effective rate of clinical treatment(89.33%) in the observation group was significantly higher than that in the control group(65.33%)(P<0.05). Compared with before treatment, the peaks of CK and CK-MB in the two groups were significantly lower, and they were lower in observation group than in the control group(P<0.05). After treatment, compared with control group, in the observation group, the improvement of left ventricular function parameters was significantly higher(P<0.05); the serum levels of HCY, IMA and Lp-PLA2 were significantly lower(P<0.05); the number of patients with cardiac death, myocardial infarction, recurrent angina, and heart failure was lower, but there was no statistical difference; the total number of adverse reactions was significantly lower(P<0.05). CONCLUSION rhBNP combined with irbesartan can protect the myocardium of patients with AMI after PCI, significantly improve the prognosis of patients, and significantly reduce the levels of HCY, IMA and Lp-PLA2 in patients.