Treatment of Heart Failure Based on Natriuretic Peptide Levels: A Question That Has Yet to be Solved?

Trials in chronic HF

Several studies have addressed the hypothesis that therapy guided by BNP or NT-proBNP would improve clinical outcomes in chronic HF. ^– Even though some of these studies demonstrated a reduction in clinical events, none of them, taken alone, was adequately powered to test the effect of this strategy on all-cause mortality.

One of the first published studies addressing this issue, published in 2000, was promising, suggesting a benefit in terms of mortality and hospitalization due to HF. Troughton et al. demonstrated a reduction in total cardiovascular events (death, hospital admission, or decompensation of HF) (19 versus 54, p = 0.02), but their study had a small number of patients (69 patients) and a short-term follow-up.

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