BNP-Guided Heart Failure Therapy: Not for Everyone

In the TIME-CHF trial, some subgroups benefited from this strategy, but no overall reduction in patient-important outcomes was achieved.

Although B-type natriuretic peptide and N-terminal proBNP (NT-proBNP) are recognized prognostic markers in patients with heart failure, their utility in guiding pharmacotherapy for heart failure is not established. Supportive findings have emerged only from trials that were small, excluded older patients, or had design limitations (JW Cardiol Apr 25 2007). These investigators studied 499 symptomatic outpatients aged ≥60 with elevated NT-proBNP levels and histories of hospitalization for heart failure. Patients were randomized to receive medical therapy guided either by symptoms or by NT-proBNP levels (BNP-guided) and were stratified into two age groups (<75 and ≥75). The analysis excluded patients with preserved LV systolic function.

At base…

Reviewing Author

Frederick A. Masoudi, MD, MSPH

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)