Carperitide
Cardiovascular / Heart FailureAlso known as: hANP, Recombinant ANP, HANP, Carperitide Acetate
Mechanism
Carperitide is recombinant human ANP (atrial natriuretic peptide) approved in Japan for treating acute heart failure. Given as a continuous IV infusion, it reduces blood pressure, promotes sodium and water excretion, and decreases cardiac preload and afterload. It has been a standard treatment for acute decompensated heart failure in Japanese hospitals since 1995.
Technical detail
Carperitide is recombinant human alpha-ANP (28-amino-acid cyclic peptide identical to endogenous ANP). Administered as continuous IV infusion, it activates NPR-A (GC-A) on vascular smooth muscle and renal epithelium, generating cGMP-PKG signaling for vasodilation, natriuresis, diuresis, and RAAS suppression. Hemodynamic effects include reduced preload (venodilation), reduced afterload (arteriolar dilation), and decreased pulmonary capillary wedge pressure. Also inhibits aldosterone secretion and sympathetic nervous system activity. Half-life approximately 2-3 minutes, requiring continuous infusion.
Evidence
- moderate
Effect of carperitide on the 1 year prognosis of patients with acute decompensated heart failure
Nogi K et al. (2022) — ESC Heart Fail — PMID: 35118813
Pooled Japanese ADHF cohort (n=2,435) found low-dose carperitide was associated with lower 1-year cardiovascular and all-cause mortality, while very-low-dose exposure was not.
- strong
Hata N et al. (2008) — Circ J — PMID: 18812677
Multicenter randomized trial in 49 ADHF patients found low-dose carperitide infusion for 72 hours reduced the composite of death or rehospitalization over 18 months versus standard therapy (11.5% vs 34.8%).
- moderate
Saito Y et al. (2005) — Circ J — PMID: 15731532
Open-label registry of 3,777 acute heart failure patients found 82% clinical improvement with carperitide; adverse events were mainly early hypotension and mortality risk tracked with age, Killip class, renal dysfunction, low blood pressure, and vasopressor use.