Heart Failure Outcomes and Benefits of NT-proBNP-Guided Management in the Elderly: Results From the Prospective, Randomized ProBNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) Study
Journal of Cardiac Failure, 08/08/2012
Gaggin HK et al. – Natriuretic peptide–guided heart failure (HF) care was well tolerated and resulted in substantial improvement in cardiovascular event rates in elders.Methods
- A total of 151 patients with HF resulting from left ventricular systolic dysfunction (LVSD) were treated with HF treatment by standard–of–care (SOC) management or guided by N–terminal pro–B type natriuretic peptide (NT–proBNP) values (with a goal to lower NT–proBNP ≤1000 pg/mL) over 10 months.
- The primary end point for this post–hoc analysis was total cardiovascular events in 2 age categories (<75 and ≥75 years).
- In those ≥75 years of age (n = 38), NT–proBNP values increased in the SOC arm (2570 to 3523 pg/mL, P = .01), but decreased in the NT–proBNP–guided arm (2664 to 1418 pg/mL, P = .001).
- Elderly patients treated with SOC management had the highest rate of cardiovascular events, whereas the elderly with NT–proBNP management had the lowest rate of cardiovascular events (1.76 events per patient versus 0.71 events per patient, P = .03); the adjusted logistic odds for cardiovascular events related to NT–proBNP–guided care for elders was 0.24 (P = .008), whereas in those <75 years (n = 113), , the adjusted logistic odds for events following NT–proBNP–guided care was 0.61 (P = .10).