ORLANDO, FLA. — Use of serial plasma B-type natriuretic peptide levels to guide medical therapy for systolic heart failure was linked to significant reductions in heart failure-related deaths and hospitalizations, Patrick Jourdain, M.D., reported at the annual meeting of the American College of Cardiology.
Half of the 220 patients in this 21-center French randomized trial received state-of-the-art, clinically guided medical therapy in accord with heart failure (HF) practice guidelines. The other half underwent monthly B-type natriuretic peptide (BNP) measurement for 3 months, then three times per year thereafter.
The goal in the BNP group was to titrate doses of ACE inhibitors, β-blockers, and diuretics until the plasma BNP dropped below 100 pg/mL.
During a median 15 months of follow-up, the BNP group had three HF-related deaths and the clinically managed group had nine. The primary end point in this unsponsored trial—HF-related death or hospitalization for HF—occurred in 25 patients in the BNP arm and 57 in the control group. This translates to a highly significant 54% reduction in relative risk when BNP was used to optimize medical management, noted Dr. Jourdain of Hôpital Rene Dubos, Pointoise, France.