Natriuretic peptide-guided treatment benefits patients without HF

  • Sweeney C & al.
  • Cochrane Database Syst Rev
  • 15 Oct 2019

  • International Clinical Digest
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Takeaway

  • Natriuretic peptide (NP)-guided treatment is tied to reduced ventricular dysfunction and all-cause hospitalisation in patients without heart failure (HF) but with high risk for cardiovascular disease.
  • The authors of this Cochrane review say that cardiovascular and all-cause mortality effects are less clear.

Why this matters

  • Some trials are in progress, and the results should clarify some of the less conclusive findings.

Key results

  • Cardiovascular benefit with NP-guided treatment was unclear (single trial, 300 participants, low-quality evidence): risk ratio (RR), 0.33 (95% CI, 0.04-3.17).
  • Risk for all-cause mortality was also unclear (2 studies, n=1354, low-quality evidence): RR, 0.90 (95% CI, 0.60-1.35).
  • Risk for cardiovascular hospitalisation is decreased (2 studies, n=1674, moderate-quality evidence): RR, 0.52 (95% CI, 0.40-0.68).
  • So was risk for all-cause hospitalisation (2 studies, n=1354, moderate-quality evidence): RR, 0.83 (95% CI, 0.75-0.92).
  • No effect of NP levels was detected.

Study design

  • Review of data from 2 randomised controlled trials (n=1674; mean age, 64.1-67.8 years; mean follow-up, 2-4.2 years).
  • Funding: National Institute for Health Research, UK; others.

Limitations

  • Only 2 studies could be included, and generalisability is limited.