Hormone-Guided Therapy Can Lower Heart Failure Mortality

Study supports using plasma levels of N-terminal pro-B-type natriuretic peptides to guide therapy

MONDAY, Jan. 4 (HealthDay News) -- Monitoring plasma levels of the hormone N-terminal pro-B-type natriuretic peptide (NT-proBNP) to guide therapy for heart failure increases three-year survival for patients 75 years old or younger compared to intensive clinical management or usual care, according to a study in the Dec. 29/Jan. 5 issue of the Journal of the American College of Cardiology.

John G. Lainchbury, M.D., of the University of Otago in Christchurch, New Zealand, and colleagues randomized 364 patients with heart failure to receive either therapy guided by monitoring of NT-proBNP levels, intensive clinical management, or usual care. The three treatment strategies were sustained for two years and follow-up was continued for three years.

The researchers found one-year mortality to be lower in the groups receiving the therapy guided by NT-proBNP levels (9.1 percent) and intensive clinical management (9.1 percent) compared to usual care (18.9 percent). For patients aged 75 years and younger, three-year mortality was much less in patients receiving NT-proBNP-guided therapy (15.5 percent) than both those receiving intensive clinical management (30.9 percent) and usual care (31.3 percent).

"Hormone-guided treatment was associated with a lower mortality rate (and also reduced mortality plus hospitalization rate) at three years compared with either intensive clinical management or usual care for patients ≤75 years of age," the authors write.

Two study authors reported receiving honoraria and/or research grants from Roche Diagnostics.

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