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Relation between therapy‐induced changes in natriuretic peptide levels and long‐term therapeutic effects on mortality in patients with heart failure and reduced ejection fraction
Author(s) -
Wessler Benjamin S.,
McCauley Michael,
Morine Kevin,
Konstam Marvin A.,
Udelson James E.
Publication year - 2019
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.1411
Subject(s) - medicine , heart failure , ejection fraction , placebo , natriuretic peptide , therapeutic effect , cardiology , brain natriuretic peptide , clinical trial , pathology , alternative medicine
Aims To assess whether natriuretic peptides (NPs) can be used to reliably predict long‐term therapeutic effect on clinical outcomes for patients with heart failure and reduced ejection fraction (HFrEF). Methods and results HFrEF intervention trials with mortality data were identified. Subsequently, we identified trials assessing therapy‐induced changes in NPs. We assessed the correlation between the average short‐term placebo‐corrected drug or device effect on NPs and the longer‐term therapeutic effect on clinical outcomes. Of 35 distinct therapies with an identifiable mortality result ( n = 105 062 patients), 20 therapies had corresponding data on therapeutic effect on NPs. No correlation was observed between therapy‐induced placebo‐corrected change in brain natriuretic peptide or N‐terminal pro‐brain natriuretic peptide and therapeutic effect on all‐cause mortality (ACM) (Spearman r = −0.32, P = 0.18 and r = −0.20, P = 0.47, respectively). There was no correlation between therapy‐induced placebo‐corrected per cent change in NP and intervention effect on ACM or ACM‐heart failure hospitalizations (r = −0.30, P = 0.11 and r = 0.10, P = 0.75, respectively). Conclusions Short‐term intervention‐induced changes in NP levels are not reliable predictors of therapeutic long‐term effect on mortality or morbidity outcomes for patients with HFrEF.