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Home All Specialties Cardiology

BNP screening in at-risk patients results in lower rates of heart dysfunction: STOP-HF Trial

bys25qthea
July 3, 2013
in Cardiology, Chronic Disease
Reading Time: 3 mins read
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Image: PD

1. Brain-type natriuretic peptide (BNP) screening and collaborative care reduced the combined rates of LV systolic dysfunction, diastolic dysfunction, and heart failure.

2. The rates of hospitalizations for cardiovascular events were significantly higher in patients not screened for BNP.

Evidence Rating Level: 1 (Excellent)

Study Rundown: While heart failure survival has improved over time, a 5-year mortality rate of nearly 50% suggest much needed new screening methods. This study is the first randomized trial to incorporate BNP levels in managing asymptomatic patients with cardiovascular risk factors, demonstrating a reduction in LV systolic dysfunction and major cardiovascular hospitalizations. Previous research suggests the potential new benefits of using BNP as a predictive factor, as BNP is thought to respond to already established cardiovascular damage and fibroinflammation, the pathophysiologic basis for many cardiovascular diseases. Limitations such as overall low event rates and thus limited generalizability, lack of blinding to the BNP intervention, and not including clinically significant endpoints such as patient reported improvement in symptoms or exercise capacity, call for further research in larger, more heterogeneous populations to more accurately determine mortality and all-cause hospitalization outcome. Overall, with additional research, BNP measurement could represent a method of identifying asymptomatic, at risk patients with increased risk of developing heart failure.

Click to read the study, published today in JAMA

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Relevant Reading: Plasma natriuretic peptide levels and the risk of cardiovascular events and death

In-Depth [prospective parallel-group randomized trial]: This study included a total of 1374 participants with cardiovascular risk factors (e.g. age>40, hypertension, hypercholesterolemia, and obesity) from 39 primary care practices in Ireland between Jan 2005 and Dec 2009 and followed until Dec 2011. Patients in the control group received lifestyle modification and risk factor intervention without BNP results. Patients in the intervention group with BNP> 50pg/mL underwent echocardiography and received multidimensional specialist interventions. The primary endpoint included asymptomatic LV systolic dysfunction, which occurred in 6.6% of control group versus 4.3% in intervention group (OR, 0.57; 95% CI, 0.370.88; P = .01). Secondary endpoints included emergency hospitalizations for major cardiovascular events for which the incidence rates were 40.4 per 1000 patient-years in the control group versus 22.3 per 1000 patient-years in the intervention group (IRR, 0.60; 95% CI, 0.45-0.81; P = .002).

By Elizabeth Park and Brittany Hasty

More from this author: Trigger exposure in migraine patients results in migraine with aura only in a small subset of patients, Choosing a prenatal diagnostic test: Microarray analysis shown equal to karyotyping,STEMO unit delivery of tpa reduces call to needle time in acute stroke patients,High-dose multivitamin supplements do not decrease disease progression or death in HIV patients receiving HAART ,Pediatric patients not receiving quality palliative care despite agreement between parents and caregivers on valued elements of care ,Combined BRAF and MEK inhibition in metastatic melanoma significantly improves progression free survival

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain. 

Tags: BNPhealthheart failureSTOP-HF
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