Navigation Links
Monitoring Protein Didn't Improve Heart Failure Outcomes
Date:1/27/2009

Study finds just watching symptoms leads to similar survival rates in older patients

TUESDAY, Jan. 27 (HealthDay News) -- Using the biomarker molecule known as brain natriuretic peptide (BNP) to guide treatment for older people with chronic heart failure did not improve the clinical outcome in most cases in a Swiss study.

There have been conflicting reports about the value of monitoring blood levels of BNP, a protein produced by stressed heart cells, for better management of heart failure. For example, a French study reported in 2007 found that BNP monitoring reduced deaths and hospitalizations in a 115-participant trial.

But the new study, published in the Jan. 28 issue of the Journal of the American Medical Association by physicians at University Hospital Basel, found that BNP-monitored therapy guidance generally did not improve 18-month survival or quality of life over conventional symptom-guided therapy.

All the people in the trial were 60 or older. All were hospitalized for heart failure, and all had BNP blood levels at least double the normal readings.

Some improvement over symptom-guided treatment was found with BNP-guided therapy for those 60 to 74, but not for those aged 75 and older.

Despite those results, BNP measurement does have a role in diagnosis and treatment of heart failure, said Dr. Gregg C. Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles.

"It is very useful in diagnosing heart failure," Fonarow said. "When someone shows up in an emergency room, BNP testing will help determine whether the cause is heart failure. Whether serial testing will improve clinical outcome remains unknown and is worthy of further study."

The Swiss trial is not definitive, because it was relatively small, with only 499 participants, Fonarow said. "All the studies to date have been rather small," he said. "It is certainly worthwhile to consider further clinical trials of serial BNP testing to guide treatment."

The finding of benefit for persons aged 60 to 74 "really needs to be confirmed by other studies," Fonarow said.

BNP testing to guide heart failure treatment can be used if its role is clearly understood, said Dr. Lavoisier J. Cardozo, a professor of medicine at Wayne State University, who said he uses it routinely.

"This study says that BNP tests can tell you stuff, and clinical examinations can tell you stuff, and you can evaluate one against the other," Cardozo said.

Using clinical evaluation of symptoms to guide treatment is better in older patients, because BNP levels go up with age, Cardozo said. "Normal changes in the heart with aging confound the issue," he said. "As you age normally, you can get heart tissue trauma and that can lead to high BNP levels. If you just read the number, you tend to overtreat. We do use BNP on every patient with heart failure, and we remember that the BNP numbers for them will be slightly higher."

While BNP testing is undoubtedly useful in helping diagnose heart failure, "I think the jury is still out on its use in guiding therapy in chronic cases," said Dr. Christopher O'Connor, a professor of medicine at Duke University and director of the Duke Heart Center who co-authored an accompanying editorial.

"The trials to date have been relatively modest in statistical power," O'Connor said. "The results of this study are encouraging and do warrant a definitive, large-scale trial that I hope will be done. I think there would be a lot of enthusiasm for such a trial."

But caution is needed in using BNP tests to guide therapy in the oldest people, O'Connor noted. "Physicians might be encouraged to be too aggressive in drug therapy to reduce BNP levels, which could result in side effects and complications with drugs," he said.

More information

Heart failure and its treatment are explained by the U.S. National Library of Medicine.



SOURCES: Gregg C. Fonarow, M.D., professor, cardiovascular medicine, University of California, Los Angeles; Lavoisier J. Cardozo, M.D., professor, medicine, Wayne State University, Detroit; Christopher O'Connor, M.D., professor, medicine, and director, Duke Heart Center, Duke University, Durham, N.C.; Jan. 28, 2009, Journal of the American Medical Association


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. System Planning Corporation Launches New Asset Tracking and Monitoring System to Meet Pharmaceutical Industry Needs
2. IntegriChain Enlists Ed Casey and Associates to Drive Counterfeit and Diversion Monitoring Service
3. Transcutaneous cervical esophageal ultrasound can not substitute for 24-h pH monitoring or manometry
4. Axeda Selected for Remote Monitoring and Service of Automation Technologies
5. Singulex Announces Presentation on Monitoring of Cardiac Biomarker to Assess Transient Myocardial Ischemia at the American Heart Association Scientific Sessions
6. Novant Health(R) Selects Cardiocom(R) to Provide Telemonitoring for Presbyterian Hospital Heart Failure Program
7. Cavidi Signs Agreement With the Clinton Foundation HIV/AIDS Initiative to Lower Costs of HIV Monitoring
8. Statement of Steve Pasierb, President and CEO, Partnership for a Drug-Free America on the Release of the 2007 Monitoring the Future Study
9. Gary Tschautscher of Nonin Medical, Inc. Receives CEO of 2007 for North American Patient Monitoring From Frost & Sullivan
10. EaglePicher Technologies Introduces First Implantable Medical Cell Designed Specifically for Monitoring Applications
11. Bergen County (NJ) Early Adopter of Health Monitoring Systems Mergence(TM) Healthcare Data Integration Engine
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Monitoring Protein Didn't Improve Heart Failure Outcomes
(Date:9/22/2017)... CA (PRWEB) , ... September 22, 2017 , ... ... to help you brush more effectively even on the go. Their electric toothbrushes ... gingivitis and gum inflammation, with UV sanitizing technology. Combining leading edge Enke technology ...
(Date:9/22/2017)... ... September 22, 2017 , ... Global Lyme Alliance ... research, education and awareness, today announced the appointment of Timothy J. Sellati, Ph.D. ... Sellati has more than 20 years of research experience with Lyme and other ...
(Date:9/21/2017)... ... 21, 2017 , ... The American Addiction Treatment Association (AATA) ... in the addiction treatment industry entitled: Special Investigations Unit (SIU) – What ... state and federal governments are increasingly scrutinizing the addiction treatment industry for fraudulent ...
(Date:9/21/2017)... ... , ... In addition to sticking with the new years ... and use natural alternatives for all house cleaning products, disinfectants, respiratory relief, and ... the new line of essential oils, are all 100% organic and natural. , ...
(Date:9/21/2017)... RICHMOND, Va. (PRWEB) , ... September 21, 2017 ... ... Richmond with a different approach to addiction recovery at a time when Virginia ... 1,420 deaths resulting from drug overdose, a staggering increase of 38 percent from ...
Breaking Medicine News(10 mins):
(Date:9/6/2017)...  Medical professionals are expected to continuously ... their patients. Medical simulations offer clinicians the ... Simulation provides a safe method for teaching ... refine techniques and build confidence, without putting ... such as augmented reality, will now provide ...
(Date:9/5/2017)... 5, 2017  Xyntek Inc. has announced another milestone in their continued growth ... to meet the growing demands of customer engagements regionally.  ... Xyntek's new Midwest office is located at 318 West Adams Street, Suite ... Xyntek's ... ...
(Date:9/1/2017)... , Sept. 1, 2017  Explorers Like Us ( https://explorerslikeus.com/ ... greatest aural experiences — and deliver these experiences as part ... help people feel and heal better. ... While nothing beats a walk, jog ... your mind, Life Environments™ is the next best thing when ...
Breaking Medicine Technology: