Heart failure, systolic, chronic: Brain natriuretic peptide (BNP) to guide therapy
DISEASE INTERVENTION COMPARISON RESULTS
Circulation. 2018 Apr 17;137(16):1671-1683 Randomized Controlled Trial, Multicenter Study
IN heart failure, acute The Use of
N-terminal pro-brain natriuretic peptide (NT-proBNP) guided therapy
As Treatment, Acute
Is equal Than
usual treatment, clinically guided
To reduce at 3 months all-cause mortality or heart failure readmissions
Arch Intern Med. 2010 Mar 22;170(6):507-14 Meta-Analysis
IN heart failure, chronic The Use of
brain natriuretic peptide (BNP) guided therapy
As Treatment, Chronic
Is better Than
usual clinical care
To reduce all-cause mortality (RR 0.76). However, there was no reduction in mortality in patients > 75 years (RR, 0.94) and no reduction of all-cause hospitalization.
J Am Coll Cardiol. 2010 Feb 16;55(7):645-53 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic The Use of
N-terminal pro-brain natriuretic peptide (NT-proBNP) guided therapy, intensive patient management
As Treatment, Chronic
Is better Than
usual care or multidisciplinary heart-failure-specialized care
To reduce number of rehospitalizations because heart failure (28% BNP VS 40% multidisciplinary VS 61% usual care) and reduce death (22% both BNP and multidisciplinary VS 39% usual care)
JAMA. 2009 Jan 28;301(4):383-92 Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic, older patients The Use of
brain natriuretic peptide (BNP) guided therapy
As Treatment, Chronic
Is equal Than
symptom-guided therapy
To improve survival free of all-cause hospitalization at 18 months: 41% BNP-guided VS 40% symptom-guided.
J Am Coll Cardiol. 2011 Oct 25;58(18):1881-9 Randomized Controlled Trial
IN heart failure, chronic, systolic, older patients The Use of
N-terminal pro-brain natriuretic peptide (NT-proBNP) guided therapy, objective < 1.000 ng/ml
As Treatment, Chronic
Is better Than
symptom-guided therapy
To total cardiovascular events (OR 0.44) and improve quality of life. No age interaction was found, with elderly patients benefitting similarly