Bias in natriuretic peptide-guided heart failure trials: time to improve guideline adherence using alternative approaches.

Abstract:

:Treatment of patients with heart failure with reduced ejection fraction (HFrEF) with currently available therapies reduces morbidity and mortality. However, implementation of these therapies is a problem with only few patients achieving guideline-recommended maximal doses of therapy. In an effort to improve guideline adherence and uptitration, several trials have investigated a biomarker-guided strategy (using natriuretic peptide targets in specific), but although conceptually promising, these trials failed to show a consistent beneficial effect on outcomes. In this review, we discuss different methodological issues that may explain the failure of these trials and offer potential solutions. Moreover, alternative approaches to increase heart failure guideline adherence are evaluated.

journal_name

Heart Fail Rev

journal_title

Heart failure reviews

authors

Stienen S,Bhatt A,Ferreira JP,Vaduganathan M,Januzzi J,Adams K,Tardif JC,Rossignol P,Zannad F

doi

10.1007/s10741-020-10004-6

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

11-21

issue

1

eissn

1382-4147

issn

1573-7322

pii

10.1007/s10741-020-10004-6

journal_volume

26

pub_type

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