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Delayed Peptide Measure Linked to Heart Failure Treatment Delay

Authors recommend prompt assessment in suspected acutely decompensated heart failure patients

WEDNESDAY, Aug. 6 (HealthDay News) -- A longer delay in measuring immunoreactive B-type natriuretic peptide (iBNP) in patients with acutely decompensated heart failure after they arrived in emergency departments was associated with a delay in treatment, according to research published in the Aug. 12 issue of the Journal of the American College of Cardiology.

Alan S. Maisel, M.D., of the Veterans Administration in San Diego, and colleagues used a national registry to analyze data on 58,465 episodes of acutely decompensated heart failure. All patients were admitted to emergency departments and given intravenous diuretics.

The investigators found that a longer time before obtaining iBNP levels was associated with prolonged time to treatment. Patients with rales on initial examination were more likely to receive earlier treatment, as were patients with a history of coronary artery disease or heart failure. In addition, delayed treatment was associated with a small increase in in-hospital mortality.

"Delays in emergency department treatment for acutely decompensated heart failure were modestly associated with increased mortality during hospitalization, independent of other prognostic variables. This effect occurred across a wide spectrum of initial iBNP levels but was most notable in patients with greater iBNP levels, suggesting that the impact of treatment delay may be amplified in more severely ill patients. Interpreting our findings in the context of previous studies, prompt measurement of iBNP levels should be considered as part of the immediate initial evaluation in patients with suspected acutely decompensated heart failure in the emergency department setting," the authors conclude.

The study was funded by Scios, Inc., which employs two of the study's co-authors.

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