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Many drugs are introduced into practice with scant information about their effects on patient outcomes. Nesiritide, a recombinant B-type natiuretic peptide, was approved by the FDA in 2001 for acute heart failure (HF) based on studies showing that it reduced pulmonary-capillary wedge pressure and symptoms after a few hours of treatment. In 2005, after pooled-study analyses, questions were raised about risks associated with the drug. In response, ASCEND-HF, an industry-sponsored trial, was launched to determine the effects of nesiritide on dyspnea, HF readmission, death, and renal function. Investigators randomized 7141 patients hospitalized with acute HF to receive nesiritide or placebo for 24 to 168 hours. The co-primary endpoints were cha…