Chronic Heart Failure Outcomes Not Improved by NT-proBNP-Guided Treatment

A Danish study found no clinical benefit from using NT-proBNP (b-type natriuretic peptide) to identify and monitor high-risk patients with chronic heart failure, according to research from the NorthStar study presented at the American College of Cardiology’s 60th Annual Scientific Session in New Orleans.

The study explored whether outcomes could be improved for patients classified as high risk because of high NT-proBNP levels by tracking that biomarker in specialized heart failure clinics (HFCs), where patients already receive optimal therapy according to European guidelines and are not discharged until they are clinically stable.

A total of 1120 clinically stable patients were randomly assigned to groups according to their risk status, as determined by NT-proBNP levels. The primary endpoints were death and a composite of hospitalization for a cardiovascular event and death.

After a median follow-up of 2.8 years, outcomes were similar for patients treated by their general practitioner (GP) and those treated in a HFC regardless of risk status. The low-risk patients had 27 deaths and 81 composite events in the GP group vs. 22 deaths and 92 composite events in the HFC group. For the high-risk patients, deaths and composite events by group were: GP, 37 and 78; HFC, 38 and 85; and HFC with monitoring, 46 and 92. The study found no increase in hospital admissions or hypotension in the GP or in the monitoring arm.

Schou M et al. NT-proBNP Stratified Long-term Follow-up in Outpatient Heart Failure Clinics: A Prospective Randomized Multicenter Trial in the Danish Heart Failure Clinics Network. Presented at ACC 2011. April 5, 2011. New Orleans, La.

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