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Heart failure outcomes and benefits of NT-proBNP-guided management in the elderly: results from the prospective, randomized ProBNP outpatient tailored chronic heart failure therapy (PROTECT) study
- Source :
- Journal of cardiac failure. 18(8)
- Publication Year :
- 2012
-
Abstract
- Elderly patients with heart failure (HF) have a worse prognosis than younger patients. We wished to study whether elders benefit from natriuretic peptide-guided HF care in this single-center study.A total of 151 patients with HF resulting from left ventricular systolic dysfunction (LVSD) were treated with HF treatment by standard-of-care (SOC) management or guided by N-terminal pro-B type natriuretic peptide (NT-proBNP) values (with a goal to lower NT-proBNP ≤1000 pg/mL) over 10 months. The primary end point for this post-hoc analysis was total cardiovascular events in 2 age categories (75 and ≥75 years). In those ≥75 years of age (n = 38), NT-proBNP values increased in the SOC arm (2570 to 3523 pg/mL, P = .01), but decreased in the NT-proBNP-guided arm (2664 to 1418 pg/mL, P = .001). Elderly patients treated with SOC management had the highest rate of cardiovascular events, whereas the elderly with NT-proBNP management had the lowest rate of cardiovascular events (1.76 events per patient versus 0.71 events per patient, P = .03); the adjusted logistic odds for cardiovascular events related to NT-proBNP-guided care for elders was 0.24 (P = .008), whereas in those75 years (n = 113), the adjusted logistic odds for events following NT-proBNP-guided care was 0.61 (P = .10).Natriuretic peptide-guided HF care was well tolerated and resulted in substantial improvement in cardiovascular event rates in elders (ClinicalTrials.Gov #00351390).
- Subjects :
- Cardiovascular event
Male
medicine.medical_specialty
Aging
medicine.drug_class
Statistics as Topic
Age categories
law.invention
Ventricular Dysfunction, Left
Randomized controlled trial
law
Internal medicine
Natriuretic Peptide, Brain
Outpatients
medicine
Clinical endpoint
Natriuretic peptide
Humans
Antihypertensive Agents
Aged
Ultrasonography
Aged, 80 and over
Heart Failure
business.industry
Disease progression
Age Factors
Middle Aged
medicine.disease
Prognosis
Peptide Fragments
Treatment Outcome
Heart failure
Physical therapy
Cardiology
Disease Progression
Biomarker (medicine)
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15328414
- Volume :
- 18
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of cardiac failure
- Accession number :
- edsair.doi.dedup.....88e26f71dc84d62171c7f158bfddc2f5