BACKGROUND: Rises in serum creatinine and efficacy have been reported as dose-related effects of nesiritide and nitroglycerin in acute decompensated heart failure (ADHF). However, no study has evaluated the comparative safety, efficacy, and biomarkers of optimally dosed nesiritide versus nitroglycerin in ADHF. METHODS AND RESULTS:Eighty-nine ADHF patients were prospectively randomized to receive either nesiritide (0.01 μg kg(-1) min(-1) ± bolus) or nitroglycerin (maximally tolerated doses by standard protocol). Blood urea nitrogen (BUN), and creatinine were obtained during 48 hours of intravenous infusion. B-Type natriuretic peptide (BNP) and N-terminal (NT) proBNP concentrations were measured during hospitalization. There were no significant differences in BUN, serum creatinine, creatinine clearance, or hospitalization and mortality. Although concentrations of BNP and NT-proBNP were significantly decreased over time, the comparative reductions between the 2 vasodilators were similar. CONCLUSIONS:Nesiritide and nitroglycerin produce similar hemodynamic effects, do not worsen markers of renal function, and produce significant, yet similar, reductions in neurohormones over time. Both nitroglycerin at maximally titrated doses and nesiritide at standard doses are safe and effective in patients with ADHF who require vasodilator therapy.
RCT Entities:
BACKGROUND: Rises in serum creatinine and efficacy have been reported as dose-related effects of nesiritide and nitroglycerin in acute decompensated heart failure (ADHF). However, no study has evaluated the comparative safety, efficacy, and biomarkers of optimally dosed nesiritide versus nitroglycerin in ADHF. METHODS AND RESULTS: Eighty-nine ADHFpatients were prospectively randomized to receive either nesiritide (0.01 μg kg(-1) min(-1) ± bolus) or nitroglycerin (maximally tolerated doses by standard protocol). Blood ureanitrogen (BUN), and creatinine were obtained during 48 hours of intravenous infusion. B-Type natriuretic peptide (BNP) and N-terminal (NT) proBNP concentrations were measured during hospitalization. There were no significant differences in BUN, serum creatinine, creatinine clearance, or hospitalization and mortality. Although concentrations of BNP and NT-proBNP were significantly decreased over time, the comparative reductions between the 2 vasodilators were similar. CONCLUSIONS: Nesiritide and nitroglycerin produce similar hemodynamic effects, do not worsen markers of renal function, and produce significant, yet similar, reductions in neurohormones over time. Both nitroglycerin at maximally titrated doses and nesiritide at standard doses are safe and effective in patients with ADHF who require vasodilator therapy.
Authors: Benjamin W Van Tassell; Nayef A Abouzaki; Claudia Oddi Erdle; Salvatore Carbone; Cory R Trankle; Ryan D Melchior; Jeremy S Turlington; Clinton J Thurber; Sanah Christopher; Dave L Dixon; Daniel T Fronk; Christopher S Thomas; Scott W Rose; Leo F Buckley; Charles A Dinarello; Giuseppe Biondi-Zoccai; Antonio Abbate Journal: J Cardiovasc Pharmacol Date: 2016-06 Impact factor: 3.105
Authors: Benjamin W Van Tassell; Leo F Buckley; Salvatore Carbone; Cory R Trankle; Justin M Canada; Dave L Dixon; Nayef Abouzaki; Claudia Oddi-Erdle; Giuseppe Biondi-Zoccai; Ross Arena; Antonio Abbate Journal: Clin Cardiol Date: 2017-05-05 Impact factor: 2.882
Authors: Pauline Alexander; Lora Alkhawam; Jason Curry; Phillip Levy; Peter S Pang; Alan B Storrow; Sean P Collins Journal: Am J Emerg Med Date: 2014-09-18 Impact factor: 2.469
Authors: David E Lanfear; Jia Li; Raza Abbas; Ricoung She; Badri Padhukasahasram; Ramesh C Gupta; David Langholz; W H Wilson Tang; L Keoki Williams; Hani N Sabbah; Sheryl L Chow Journal: J Cardiovasc Transl Res Date: 2015-11-20 Impact factor: 4.132
Authors: Meaghan Lunney; Marinella Ruospo; Patrizia Natale; Robert R Quinn; Paul E Ronksley; Ioannis Konstantinidis; Suetonia C Palmer; Marcello Tonelli; Giovanni Fm Strippoli; Pietro Ravani Journal: Cochrane Database Syst Rev Date: 2020-02-27