ORLANDO, Fla. (Ivanhoe Newswire) -- Although past research suggests heart
failure treatment guided by the biomarker BNP may be superior to symptom-guided
treatment, a new study contradicts that idea.
N-terminal brain natriuretic peptide, or BNP, is produced by heart muscle cells.
Since its levels increase in patients with heart failure, some doctors have been
using the peptide as a treatment guide as they would use symptoms in
conventional treatment.
While some studies have shown BNP-guided heart failure therapy to be more
beneficial than therapy guided by symptoms alone, a new JAMA study suggests this
is not true. Researchers at the University Hospital Basel in Switzerland
compared the BNP-guided strategy with traditional symptom-guided treatment in
almost 500 heart failure patients who were at least 60 years old.
Findings show BNP-guided therapy didn't significantly improve overall patient
survival rates. While therapy guided by BNP levels did show some benefits over
traditional therapy in patients between the ages of 60 and 75, it didn't improve
outcomes in those over 75.
Ileana Pina, M.D., of Case Western Reserve University and Louis Stokes VA
Medical Center in Cleveland, Ohio, who authored the accompanying editorial, said
the results of the study don't surprise her.
"This measurement [BNP] needs to be taken within the context of a good history
and physical exam," Dr. Pina told Ivanhoe.
She said the next study on BNP-guided treatment should look into specific ways
to treat patients who have high BNPs and ask questions like, "Do you chase the
BNPs and try to lower them?" and "What medications do you use?"
SOURCE: Ivanhoe interview with Ileana Pina, M.D.; Journal of the American
Medical Association, 2009;301:383-392
