BNP-Guided Heart Treatment Disappoints

BNP-Guided Heart Treatment Disappoints

Reported January 30, 2009

ORLANDO, Fla. (Ivanhoe Newswire) — Although past research suggests heart failure treatment guided by the biomarker BNP may be superior to symptom-guided treatment, a new study contradicts that idea.

N-terminal brain natriuretic peptide, or BNP, is produced by heart muscle cells. Since its levels increase in patients with heart failure, some doctors have been using the peptide as a treatment guide as they would use symptoms in conventional treatment.

While some studies have shown BNP-guided heart failure therapy to be more beneficial than therapy guided by symptoms alone, a new JAMA study suggests this is not true. Researchers at the University Hospital Basel in Switzerland compared the BNP-guided strategy with traditional symptom-guided treatment in almost 500 heart failure patients who were at least 60 years old.



Findings show BNP-guided therapy didn’t significantly improve overall patient survival rates. While therapy guided by BNP levels did show some benefits over traditional therapy in patients between the ages of 60 and 75, it didn’t improve outcomes in those over 75.

Ileana Pina, M.D., of Case Western Reserve University and Louis Stokes VA Medical Center in Cleveland, Ohio, who authored the accompanying editorial, said the results of the study don’t surprise her.

“This measurement [BNP] needs to be taken within the context of a good history and physical exam,” Dr. Pina told Ivanhoe.

She said the next study on BNP-guided treatment should look into specific ways to treat patients who have high BNPs and ask questions like, “Do you chase the BNPs and try to lower them?” and “What medications do you use?”

SOURCE: Ivanhoe interview with Ileana Pina, M.D.; Journal of the American Medical Association, 2009;301:383-392