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Thursday, April 19, 2007

Brain Natriuretic Peptide (BNP) and Heart Failure

Protein Monitoring Improved Heart Failure Treatment French trial found fewer deaths and hospital stays

WEDNESDAY, April 18 (HealthDay News) -- A trial that used blood levels of a biomarker called brain natriuretic peptide (BNP) to guide treatment of heart failure more than halved the incidence of death or hospitalization for the condition over 15 months, French cardiologists report.

Just 24 percent of the 110 trial participants whose drug treatment was adjusted according to BNP levels reached those critical end points of death or hospitalization. That compared to 52 percent of those who did not get BNP monitoring.

There were seven deaths from heart failure in the BNP-monitored group, compared to 11 in the non-monitored patients. The overall incidence of hospitalization was about the same in both groups, but just 22 hospital stays due to heart failure complications in the monitored group compared to 48 among patients whose BNP levels were not monitored.

The major difference in medical treatment was use of higher doses of beta-blocker and ACE inhibitor drugs in the BNP-monitored group, the researchers said.

BNP is a protein produced by the muscle cells of the heart ventricles as a response to excess stretching of those cells. Tests of BNP blood levels are used to help diagnosis heart failure, a condition in which the heart progressively loses its ability to pump blood, and to assess the prognosis for people with heart failure. Most drugs used to treat heart failure lower BNP levels.

The study participants, whose average age was 65, had essentially similar symptoms at the start of the trial, although those in the BNP-monitored group had a slightly lower average ejection fraction, which measures the heart's blood-pumping ability.

The findings are published in the April 24 issue of the Journal of the American College of Cardiology .

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