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学科主题临床医学
B-type Natriuretic Peptide-guided Chronic Heart Failure Therapy: A Meta-analysis of 11 Randomised Controlled Trials
Li, Peng1; Luo, Yong1; Chen, Yi-Ming2
关键词Bnp Chronic Heart Failure Prognosis Rehospitalisation
刊名HEART LUNG AND CIRCULATION
2013-10-01
DOI10.1016/j.hlc.2013.03.077
22期:10页:852-860
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Cardiac & Cardiovascular Systems
研究领域[WOS]Cardiovascular System & Cardiology
关键词[WOS]VENTRICULAR SYSTOLIC DYSFUNCTION ; INTERVENTION TRIAL ; DOUBLE-BLIND ; NT-PROBNP ; VAL-HEFT ; MERIT-HF ; CARE ; MORTALITY ; BNP ; MANAGEMENT
英文摘要

Background: The use of plasma levels of B-type natriuretic peptides (BNPs) to guide treatment of patients with chronic heart failure (HF) has been investigated in a number of randomised controlled trials (RCTs). However, the benefits have been variable. We therefore performed a meta-analysis to examine the overall effect of BNP-guided drug therapy on all-cause mortality and HF rehospitalisation in patients with chronic HE

Methods: We identified RCTs by systematic search of MEDLINE, EMBASE and the Cochrane Controlled Clinical Trials Register Database. Eligible RCTs were those that enrolled more than 40 patients and involved comparison of BNP-guided versus guideline-guided drug therapy of the patients with chronic HF in the outpatient setting.

Results: Eleven RCTs with a total of 2414 patients and with a mean duration of 12 months (range, 3-36 months) were included in the meta-analysis. Overall, there was a significantly decreased risk of all-cause mortality (relative risk [RR], 0.83; 95% confidence interval [CI], 0.69-0.99; P = 0.035; I-2 = 0%) and HF rehospitalisation (RR, 0.75; 95% CI, 0.62-0.91; P = 0.004; I-2 = 62.2%) in the BNP-guided therapy group. Age, baseline BNP are the major dominants of HF rehospitalisation when analysed using meta-regression. In the subgroup analysis, HF rehospitalisation was significantly decreased in the patients younger than 70 years (RR, 0.45; 95% CI, 0.33-0.61;P = 0.000; I-2 = 0.0%), or with baseline higher BNP (>= 2114 pg/mL) (RR, 0.53; 95% CI, 0.39-0.72; P = 0.000; I-2 = 21.8%).

Conclusions: Compared with usual clinical care, B-type natriuretic peptide-guided therapy reduces all-cause mortality and HF rehospitalisation, especially in patients younger than 70 years or with higher baseline BNP. (C) 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.

语种英语
WOS记录号WOS:000326428400008
Citation statistics
Cited Times:17[WOS]   [WOS Record]     [Related Records in WOS]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/53764
Collection北京大学首钢医院
作者单位1.Peking Univ, Shougang Hosp, Dept ICU, Beijing 100871, Peoples R China
2.Capital Med Univ, Beijing Chao Yang Hosp, Dept Pediat, Beijing, Peoples R China
Recommended Citation
GB/T 7714
Li, Peng,Luo, Yong,Chen, Yi-Ming. B-type Natriuretic Peptide-guided Chronic Heart Failure Therapy: A Meta-analysis of 11 Randomised Controlled Trials[J]. HEART LUNG AND CIRCULATION,2013,22(10):852-860.
APA Li, Peng,Luo, Yong,&Chen, Yi-Ming.(2013).B-type Natriuretic Peptide-guided Chronic Heart Failure Therapy: A Meta-analysis of 11 Randomised Controlled Trials.HEART LUNG AND CIRCULATION,22(10),852-860.
MLA Li, Peng,et al."B-type Natriuretic Peptide-guided Chronic Heart Failure Therapy: A Meta-analysis of 11 Randomised Controlled Trials".HEART LUNG AND CIRCULATION 22.10(2013):852-860.
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