Pulmonary Artery Pressure-Guided Tx Cuts Hospitalizations
Monitoring leads to more targeted interventions in heart failure patients
THURSDAY, Feb. 18, 2016 (HealthDay News) -- Ambulatory pulmonary artery (PA) pressure-guided management of heart failure patients is more effective in reducing heart failure hospitalizations than management of patient clinical signs/symptoms alone, according to a study published online Feb. 10 in JACC: Heart Failure.
Maria R. Costanzo, M.D., from the Advocate Heart Institute in Naperville, Ill., and colleagues randomized 550 class III heart failure patients (with a heart failure hospitalization in the prior year) to active monitoring (PA pressure-guided heart failure management plus standard of care) or to the blind therapy group (heart failure management by standard clinical assessment). Participants were followed for a minimum of six months.
The researchers found that after follow-up the active monitoring patients had a higher frequency of medication adjustments; significant increases in the doses of diuretics, vasodilators, and neurohormonal antagonists; targeted intensification of diuretics and vasodilators in those with higher PA pressures; and preservation of renal function despite diuretic intensification.
"Incorporation of a PA pressure-guided treatment algorithm to decrease filling pressures led to targeted changes, particularly in diuretics and vasodilators, and was more effective in reducing heart failure hospitalizations than management of patient clinical signs/symptoms alone," the authors write.
Several authors disclosed financial ties to the medical device industry.