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Carperitide Is Associated With Increased In-Hospital Mortality in Acute Heart Failure: A Propensity Score-Matched
Yuya Matsue1, Nobuyuki Kagiyama2, Kazuki Yoshida3
1Department of Cardiology, Kameda Medical Center, Chiba, Japan.
Insights
Carperitide treatment in acute heart failure (AHF) patients was linked to higher in-hospital mortality. Further research is needed to confirm the safety and effectiveness of carperitide in AHF care.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Research
Background:
- Carperitide (α-human A-type natriuretic peptide) is widely used for acute heart failure (AHF) in Japan.
- Its clinical effectiveness and safety in AHF patients remain under-documented.
Purpose of the Study:
- To evaluate the association between carperitide treatment and in-hospital mortality in AHF patients.
- To investigate potential differential effects in subgroups, such as elderly patients.
Main Methods:
- Retrospective analysis of AHF patients admitted to three hospitals.
- Propensity score-matched analysis comparing patients treated with and without carperitide.
- Primary endpoint: in-hospital mortality.
Main Results:
- Carperitide was administered to 38.7% of the AHF cohort, with an overall in-hospital mortality of 7.6%.
- In a propensity score-matched cohort (367 pairs), carperitide use was significantly associated with increased in-hospital mortality (OR 2.13, P = .013).
- Increased mortality risk was particularly noted in elderly patients (OR 2.93).
Conclusions:
- Carperitide use was significantly associated with higher in-hospital mortality rates in AHF patients.
- The findings highlight potential safety concerns, especially in the elderly.
- Well-designed randomized clinical trials are crucial to definitively establish carperitide's safety and effectiveness in AHF.
Background:
Carperitide (α-human A-type natriuretic peptide) has been used for more than one-half of all acute heart failure (AHF) patients in Japan. However, its clinical effectiveness is not well documented.
Methods:
We retrospectively identified AHF patients presenting with acute onset or worsening of symptoms and admitted to 1 of the 3 participating hospitals. Propensity score-matched analysis was performed. The primary end point was in-hospital mortality.
Results:
Of all of the AHF patients included in this study, 402 (38.7%) were treated with carperitide, and in-hospital mortality rate for the total cohort was 7.6%. We matched 367 pairs of patients treated with and without carperitide according to propensity score. In this matched cohort, treatment with carperitide was associated with in-hospital mortality (odds ratio [OR] 2.13, 95% confidence interval [CI] 1.17-3.85; P = .013). Potentially more harmful effects were observed in elderly patients (OR 2.93, 95% CI 1.54-5.91).
Conclusions:
Carperitide was significantly associated with increased in-hospital mortality rate in AHF patients. Our results strongly suggest the necessity for well designed randomized clinical trials of carperitide to determine its clinical safety and effectiveness.
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