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BNP-Guided Treatment Helps Heart Failure Outcome

Lowering BNP levels reduces CHF-related deaths, hospital stays

TUESDAY, April 17 (HealthDay News) -- A strategy of reducing plasma brain natriuretic peptide (BNP) levels in patients with chronic heart failure lowers the risk of death and hospital stays compared to standard care, according to results from the STARS-BNP multicenter study published in the April 24 issue of Journal of the American College of Cardiology.

Patrick Jourdain, M.D., of Rene Descartes University, Paris, France, and colleagues randomized 220 heart failure patients with New York Heart Association functional class II and III to either standard care or care with the goal of decreasing BNP levels. All patients were optimally treated with angiotensin-converting enzyme inhibitors, beta-blockers, and diuretics.

After a mean follow-up of 15 months, 24 percent of patients in the BNP-guided strategy group reached the combined end-point of heart failure-related death or hospital stay compared with 52 percent of the standard-care group. This was accomplished largely through adjustments in ACE inhibitors and beta-blockers, which were used more frequently at three months in the BNP group.

"This study has shown that chronic heart failure treatment optimization based on plasma BNP levels is associated with a lower risk of death related to heart failure or hospital stay related to heart failure than the usual strategy based on clinical expertise," the authors wrote. "The benefit was observed despite optimization of therapy in both groups by cardiologists specialized in congestive heart failure before entry into the study."

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