Does B-type natriuretic peptide-guided therapy improve outcomes in patients with chronic heart failure? A systematic review and meta-analysis of randomized controlled trials

Verfasser / Beitragende:
[Wei Xin, Zhiqin Lin, Shuhua Mi]
Ort, Verlag, Jahr:
2015
Enthalten in:
Heart Failure Reviews, 20/1(2015-01-01), 69-80
Format:
Artikel (online)
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024 7 0 |a 10.1007/s10741-014-9437-8  |2 doi 
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245 0 0 |a Does B-type natriuretic peptide-guided therapy improve outcomes in patients with chronic heart failure? A systematic review and meta-analysis of randomized controlled trials  |h [Elektronische Daten]  |c [Wei Xin, Zhiqin Lin, Shuhua Mi] 
520 3 |a The role of B-type natriuretic peptide (BNP) in the management of patients with chronic heart failure (CHF) was uncertain. The aim of this meta-analysis was to comprehensively evaluate the effect of BNP-guided therapy in CHF. Relevant randomized controlled trials were identified by searching of Pubmed, Embase and the Cochrane Library databases. Fixed or randomized effect models were applied to combine the data according to the heterogeneity of the included studies. Fourteen studies with 3,004 CHF patients were included. Results of our meta-analyses suggested that compared with clinical group, BNP-guided treatment significantly decreased the risk of heart failure-related hospitalization (RR 0.79, 95% CI 0.63-0.98, p=0.03), although did not significantly affect the risk of all-cause mortality (RR 0.94, 95% CI 0.81-1.08, p=0.39) or all-cause hospitalization (RR 0.97, 95% CI 0.89-1.07, p=0.56). Furthermore, between-group BNP changes seemed to be a significant modifier to the effects of BNP-guided therapy on clinical outcomes, and BNP-guided therapy may improve the clinical outcomes of CHF patients if substantial reduction of BNP can be achieved. In addition, BNP-guided therapy was not associated with increased risk for serious adverse events. BNP-guided therapy may improve the clinical outcomes of CHF patients if substantial reduction of BNP can be achieved. BNP-guided therapy seemed to be safe and promising for CHF patients, and future studies with well-designed BNP-guided medication up-titration strategies are needed to confirm these results. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a B-type natriuretic peptide  |2 nationallicence 
690 7 |a N-terminal pro-B-type natriuretic peptide  |2 nationallicence 
690 7 |a Chronic heart failure  |2 nationallicence 
690 7 |a Meta-analysis  |2 nationallicence 
690 7 |a CHF : Chronic heart failure  |2 nationallicence 
690 7 |a BNP : B-type natriuretic peptide  |2 nationallicence 
690 7 |a NT-proBNP : N-terminal pro-B-type natriuretic peptide  |2 nationallicence 
690 7 |a HF : Heart failure  |2 nationallicence 
690 7 |a ACEIs : Angiotensin-converting enzyme inhibitors  |2 nationallicence 
690 7 |a ARBs : Angiotensin II receptor blockers  |2 nationallicence 
690 7 |a AAs : Aldosterone antagonists  |2 nationallicence 
690 7 |a LVEF : Left ventricular ejection fraction  |2 nationallicence 
690 7 |a NYHA : New York Heart Association  |2 nationallicence 
690 7 |a MLHFQS : Minnesota Living with Heart Failure Questionnaire Score  |2 nationallicence 
690 7 |a RR : Risk ratio  |2 nationallicence 
690 7 |a CI : Confidence interval  |2 nationallicence 
690 7 |a WMD : Weighed mean difference  |2 nationallicence 
700 1 |a Xin  |D Wei  |u Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China  |4 aut 
700 1 |a Lin  |D Zhiqin  |u Department of Cardiovascular Medicine, Affiliated Hospital of Guiyang Medical College, Guiyang, Guizhou, China  |4 aut 
700 1 |a Mi  |D Shuhua  |u Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China  |4 aut 
773 0 |t Heart Failure Reviews  |d Springer US; http://www.springer-ny.com  |g 20/1(2015-01-01), 69-80  |x 1382-4147  |q 20:1<69  |1 2015  |2 20  |o 10741 
856 4 0 |u https://doi.org/10.1007/s10741-014-9437-8  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Xin  |D Wei  |u Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lin  |D Zhiqin  |u Department of Cardiovascular Medicine, Affiliated Hospital of Guiyang Medical College, Guiyang, Guizhou, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Mi  |D Shuhua  |u Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Heart Failure Reviews  |d Springer US; http://www.springer-ny.com  |g 20/1(2015-01-01), 69-80  |x 1382-4147  |q 20:1<69  |1 2015  |2 20  |o 10741