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Effect of B-type na...
Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization : an individual patient meta-analysis
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- Troughton, Richard W. (författare)
- University of Otago Christchurch, New Zealand
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- Frampton, Christopher M. (författare)
- University of Otago Christchurch, New Zealand
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- Brunner-La Rocca, Hans-Peter (författare)
- Maastricht University of Medical Centre, Netherlands
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- Pfisterer, Matthias (författare)
- University Hospital Basel, Switzerland.
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- Eurlings, Luc W. M. (författare)
- Maastricht University of Medical Centre, Netherlands
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- Erntell, Hans (författare)
- Karolinska Institutet
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- Persson, Hans (författare)
- Karolinska Institutet
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- O'Connor, Christopher M. (författare)
- Duke University Medical Center, Durham, NC, USA
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- Moertl, Deddo (författare)
- LKH, St Poelten, Austria
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- Karlström, Patric (författare)
- County Hospital Ryhov, Jönköping, Sweden
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- Dahlström, Ulf (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Kardiologiska kliniken US
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- Gaggin, Hanna K. (författare)
- Massachusetts General Hospital, Boston, USA
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- Januzzi, James L. (författare)
- Massachusetts General Hospital, Boston, USA
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- Berger, Rudolf (författare)
- Medical University of Vienna, Austria
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- Richards, A. Mark (författare)
- University of Otago Christchurch, New Zealand
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- Pinto, Yigal M. (författare)
- Academic Medical Center, Amsterdam, The Netherlands
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- Nicholls, M. Gary (författare)
- University of Otago Christchurch, New Zealand
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(creator_code:org_t)
- 2014-03-06
- 2014
- Engelska.
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 35:23, s. 1559-1567
- Relaterad länk:
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https://europepmc.or...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
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- Aims Natriuretic peptide-guided (NP-guided) treatment of heart failure has been tested against standard clinically guided care in multiple studies, but findings have been limited by study size. We sought to perform an individual patient data meta-analysis to evaluate the effect of NP-guided treatment of heart failure on all-cause mortality. Methods and results ligible randomized clinical trials were identified from searches of Medline and EMBASE databases and the Cochrane Clinical Trials Register. The primary pre-specified outcome, all-cause mortality was tested using a Cox proportional hazards regression model that included study of origin, age (less than 75 or greater than= 75 years), and left ventricular ejection fraction (LVEF, less than= 45 or greater than 45%) as covariates. Secondary endpoints included heart failure or cardiovascular hospitalization. Of 11 eligible studies, 9 provided individual patient data and 2 aggregate data. For the primary endpoint individual data from 2000 patients were included, 994 randomized to clinically guided care and 1006 to NP-guided care. All-cause mortality was significantly reduced by NP-guided treatment [hazard ratio = 0.62 (0.45-0.86); P = 0.004] with no heterogeneity between studies or interaction with LVEF. The survival benefit from NP-guided therapy was seen in younger (less than 75 years) patients [0.62 (0.45-0.85); P = 0.004] but not older (greater than= 75 years) patients [0.98 (0.75-1.27); P = 0.96]. Hospitalization due to heart failure [0.80 (0.67-0.94); P = 0.009] or cardiovascular disease [0.82 (0.67-0.99); P = 0.048] was significantly lower in NP-guided patients with no heterogeneity between studies and no interaction with age or LVEF. Conclusion Natriuretic peptide-guided treatment of heart failure reduces all-cause mortality in patients aged less than 75 years and overall reduces heart failure and cardiovascular hospitalization.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Natriuretic peptides; B-type Natriuretic peptide; Heart failure
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Troughton, Richa ...
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Frampton, Christ ...
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Brunner-La Rocca ...
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Pfisterer, Matth ...
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Eurlings, Luc W. ...
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Erntell, Hans
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visa fler...
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Persson, Hans
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O'Connor, Christ ...
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Moertl, Deddo
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Karlström, Patri ...
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Dahlström, Ulf
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Gaggin, Hanna K.
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Januzzi, James L ...
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Berger, Rudolf
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Richards, A. Mar ...
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Pinto, Yigal M.
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Nicholls, M. Gar ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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European Heart J ...
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Linköpings universitet
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Karolinska Institutet