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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.
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https://hal.univ-lorraine.fr/hal-02919808
Contributor : Erwan Bozec <>
Submitted on : Monday, August 24, 2020 - 10:17:47 AM
Last modification on : Wednesday, February 10, 2021 - 1:31:43 PM
Long-term archiving on: : Tuesday, December 1, 2020 - 5:46:50 AM

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Susan Stienen, Ankeet Bhatt, Joao Pedro Ferreira, Muthiah Vaduganathan, James Januzzi, et al.. Bias in natriuretic peptide-guided heart failure trials: time to improve guideline adherence using alternative approaches. Heart Failure Reviews, Springer Verlag, 2020, 26 (1), pp.11-21. ⟨10.1007/s10741-020-10004-6⟩. ⟨hal-02919808⟩

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