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Effectiveness of natriuretic peptide-guided treatment of chronic heart failure. A meta-analysis
Ana-Estela Gamiño-Arroyo1, Francisco-Javier Prado-Galbarro2, Sonia García-Pérez3
1Unidad de Infectología, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico.
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.
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