Effect of Nesiritide in Patients with Acute Decompensated Heart Failure

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dc.contributor.authorO'Connor, C. M.
dc.contributor.authorStarling, R. C.
dc.contributor.authorHernandez, A. F.
dc.contributor.authorArmstrong, P. W.
dc.contributor.authorDickstein, K.
dc.contributor.authorHasselblad, V.
dc.contributor.authorHeizer, G. M.
dc.contributor.authorKomajda, M.
dc.contributor.authorMassie, B. M.
dc.contributor.authorMcMurray, J. J. V.
dc.contributor.authorNieminen, M. S.
dc.contributor.authorReist, C. J.
dc.contributor.authorRouleau, J. L.
dc.contributor.authorSwedberg, K.
dc.contributor.authorAdams, K. F., Jr.
dc.contributor.authorAnker, S. D.
dc.contributor.authorAtar, D.
dc.contributor.authorBattler, A.
dc.contributor.authorBotero, R.
dc.contributor.authorBohidar, N. R.
dc.contributor.authorButler, J.
dc.contributor.authorClausell, N.
dc.contributor.authorCorbalan, R.
dc.contributor.authorCostanzo, M. R.
dc.contributor.authorDahlstrom, U.
dc.contributor.authorDeckelbaum, L. I.
dc.contributor.authorDiaz, R.
dc.contributor.authorDunlap, M. E.
dc.contributor.authorEzekowitz, J. A.
dc.contributor.authorFeldman, D.
dc.contributor.authorFelker, G. M.
dc.contributor.authorFonarow, G. C.
dc.contributor.authorGennevois, D.
dc.contributor.authorGottlieb, S. S.
dc.contributor.authorHill, J. A.
dc.contributor.authorHollander, J. E.
dc.contributor.authorHowlett, J. G.
dc.contributor.authorHudson, M. P.
dc.contributor.authorKociol, R. D.
dc.contributor.authorKrum, H.
dc.contributor.authorLaucevicius, A.
dc.contributor.authorLevy, W. C.
dc.contributor.authorMendez, G. F.
dc.contributor.authorMetra, M.
dc.contributor.authorMittal, S.
dc.contributor.authorOh, B. H.
dc.contributor.authorPereira, N. L.
dc.contributor.authorPonikowski, P.
dc.contributor.authorWilson, W. H.
dc.contributor.authorTanomsup, S.
dc.contributor.authorTeerlink, J. R.
dc.contributor.authorTriposkiadis, F.
dc.contributor.authorTroughton, R. W.
dc.contributor.authorVoors, A. A.
dc.contributor.authorWhellan, D. J.
dc.contributor.authorZannad, F.
dc.contributor.authorCaliff, R. M.
dc.date.accessioned2024-01-10T12:05:06Z
dc.date.available2024-01-10T12:05:06Z
dc.date.issued2011
dc.description.abstractBackground
dc.description.abstractNesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent.
dc.description.abstractMethods
dc.description.abstractWe randomly assigned 7141 patients who were hospitalized with acute heart failure to receive either nesiritide or placebo for 24 to 168 hours in addition to standard care. Coprimary end points were the change in dyspnea at 6 and 24 hours, as measured on a 7-point Likert scale, and the composite end point of rehospitalization for heart failure or death within 30 days.
dc.description.abstractResults
dc.description.abstractPatients randomly assigned to nesiritide, as compared with those assigned to placebo, more frequently reported markedly or moderately improved dyspnea at 6 hours (44.5% vs. 42.1%, P = 0.03) and 24 hours (68.2% vs. 66.1%, P = 0.007), but the prespecified level for significance (P = 0.005 for both assessments or Pd <= 0.0025 for either) was not met. The rate of rehospitalization for heart failure or death from any cause within 30 days was 9.4% in the nesiritide group versus 10.1% in the placebo group (absolute difference, -0.7 percentage points; 95% confidence interval [CI], -2.1 to 0.7; P = 0.31). There were no significant differences in rates of death from any cause at 30 days (3.6% with nesiritide vs. 4.0% with placebo; absolute difference, -0.4 percentage points; 95% CI, -1.3 to 0.5) or rates of worsening renal function, defined by more than a 25% decrease in the estimated glomerular filtration rate (31.4% vs. 29.5%; odds ratio, 1.09; 95% CI, 0.98 to 1.21; P = 0.11).
dc.description.abstractConclusions
dc.description.abstractNesiritide was not associated with an increase or a decrease in the rate of death and rehospitalization and had a small, nonsignificant effect on dyspnea when used in combination with other therapies. It was not associated with a worsening of renal function, but it was associated with an increase in rates of hypotension. On the basis of these results, nesiritide cannot be recommended for routine use in the broad population of patients with acute heart failure.
dc.description.funderScios
dc.fechaingreso.objetodigital2024-05-06
dc.format.extent12 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1056/NEJMoa1100171
dc.identifier.eissn1533-4406
dc.identifier.issn0028-4793
dc.identifier.urihttps://doi.org/10.1056/NEJMoa1100171
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/75947
dc.identifier.wosidWOS:000292459400007
dc.information.autorucMedicina;Corbalan R ;S/I;98700
dc.issue.numero1
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final43
dc.pagina.inicio32
dc.publisherMASSACHUSETTS MEDICAL SOC
dc.revistaNEW ENGLAND JOURNAL OF MEDICINE
dc.rightsregistro bibliográfico
dc.subjectHOSPITALIZED-PATIENTS
dc.subjectOUTCOMES
dc.subjectDIURETICS
dc.subjectRISK
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleEffect of Nesiritide in Patients with Acute Decompensated Heart Failure
dc.typeartículo
dc.volumen365
sipa.codpersvinculados98700
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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