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Archivos de cardiología de México
On-line version ISSN 1665-1731Print version ISSN 1405-9940
Abstract
GAMINO-ARROYO, Ana-Estela; PRADO-GALBARRO, Francisco-Javier; GARCIA-PEREZ, Sonia and SANCHEZ-PIEDRA, Carlos. Effectiveness of natriuretic peptide-guided treatmen of chronic heart failure. A meta-analysis. Arch. Cardiol. Méx. [online]. 2018, vol.88, n.3, pp.171-177. ISSN 1665-1731. https://doi.org/10.1016/j.acmx.2017.02.008.
Objective:
To evaluate the efficacy of natriuretic peptide (NP)-guided therapy compared to clinically-guided therapy in reducing mortality and hospital admissions in chronic heart failure (HF) patients.
Methods:
Randomised clinical trials (RCT) were selected through a systematic review. Four meta-analyses were conducted for the outcomes of overall mortality, HF-related mortality, overall hospital admissions, and HF-related hospital admissions. Heterogeneity between studies and publication bias were also assessed.
Results:
Nine RCTs were found with a total of 1914 patients. NP-guided therapy significantly reduced overall mortality and HF-related hospital admissions. No significant results were found for HF-related mortality and overall hospital admissions. Some clinical heterogeneity regarding interventions performed was found between studies. Publication bias was found for HF-related and overall hospital admissions.
Conclusions:
NP-guided therapy seems to improve outcomes compared to clinically-guided therapy. However, heterogeneity found between interventions might reduce the generalisation of these results. Specific interventions of the clinical trials should be examined when making recommendations regarding NP-guided therapy.
© 2017 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/).
Keywords : Heart failure; Natriuretic peptide; Meta-analysis; Therapy; NT-proBNP; Mexico.