caa a22 4500 605478643 CHVBK 20210128100406.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s10741-014-9437-8 doi (NATIONALLICENCE)springer-10.1007/s10741-014-9437-8 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 [Elektronische Daten] [Wei Xin, Zhiqin Lin, Shuhua Mi] 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. Springer Science+Business Media New York, 2014 B-type natriuretic peptide nationallicence N-terminal pro-B-type natriuretic peptide nationallicence Chronic heart failure nationallicence Meta-analysis nationallicence CHF : Chronic heart failure nationallicence BNP : B-type natriuretic peptide nationallicence NT-proBNP : N-terminal pro-B-type natriuretic peptide nationallicence HF : Heart failure nationallicence ACEIs : Angiotensin-converting enzyme inhibitors nationallicence ARBs : Angiotensin II receptor blockers nationallicence AAs : Aldosterone antagonists nationallicence LVEF : Left ventricular ejection fraction nationallicence NYHA : New York Heart Association nationallicence MLHFQS : Minnesota Living with Heart Failure Questionnaire Score nationallicence RR : Risk ratio nationallicence CI : Confidence interval nationallicence WMD : Weighed mean difference nationallicence Xin Wei Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China aut Lin Zhiqin Department of Cardiovascular Medicine, Affiliated Hospital of Guiyang Medical College, Guiyang, Guizhou, China aut Mi Shuhua Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China aut Heart Failure Reviews Springer US; http://www.springer-ny.com 20/1(2015-01-01), 69-80 1382-4147 20:1<69 2015 20 10741 https://doi.org/10.1007/s10741-014-9437-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10741-014-9437-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Xin Wei Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China aut NATIONALLICENCE 700 1- Lin Zhiqin Department of Cardiovascular Medicine, Affiliated Hospital of Guiyang Medical College, Guiyang, Guizhou, China aut NATIONALLICENCE 700 1- Mi Shuhua Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China aut NATIONALLICENCE 773 0- Heart Failure Reviews Springer US; http://www.springer-ny.com 20/1(2015-01-01), 69-80 1382-4147 20:1<69 2015 20 10741