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Elevated B-type natriuretic peptide (BNP) levels correlate with adverse outcomes in patients with heart failure and are, in some cases, reduced by evidence-based HF pharmacotherapy. However, evidence to support the use of BNP levels to guide HF treatment is limited.
In this manufacturer-sponsored, multicenter study, French investigators randomized 220 adults (mean age, 65; 73% men) with HF, NYHA class II or III symptoms, and LV systolic dysfunction (mean LV ejection fraction, 30%) to either BNP-guided therapy, aiming for BNP levels below 100 pg/mL, or standard medical therapy without BNP measurements. At baseline, almost all patients were taking beta-blockers and either an ACE inhibitor or an angiotensin-receptor blocker (ARB). Although the …