Source: DGNews  |  Posted 8 years ago

By Roberta Friedman, PhD

LAS VEGAS, NV -- September 23, 2003 -- Nesiritide therapy is able to cut in half the risk of dying in hospital with heart failure compared to treating with inotropes, according to data gleaned from a registry of more than 33,000.

The findings were presented here September 22nd at the 2003 Annual Meeting of the Heart Failure Society of America.

Investigator William Abraham, MD, department of cardiology, Ohio State University, Columbus, Ohio, said that nesiritide and the old standby, nitroglycerin, are more effective in treating patients with decompensated heart failure than are the inotropes -- dobutamine and milrinone. Inotropes should only be used as a last recourse, he said.

Dr. Abraham said the registry was unable to prove that the new recombinant B type natriuretic peptide, nesiritide, was statistically more effective than nitroglycerin. But previous randomized, controlled studies showed that nesiritide is superior to nitroglycerin for advanced heart failure, he added. The registry did yield a trend for nesiritide to be better than the older drug, he said.

Investigators looked at data from the first 33,046 patients enrolled in ADHERE (Acute Decompensated HEart Failure National REgistry). More than 250 hospitals in the United States are contributing data to this registry, a web based collection method that will build to include more than a hundred thousand patients by year's end.

Those patients who received nesiritide while in hospital for their heart failure had an adjusted odds ratio of risk and propensity score for mortality of 0.9 compared to nitroglycerine, and of 0.58 and 0.46 for the comparison with milrinone and dobutamine, respectively (P<0.0001 for the comparison with inotropes).

Scios Inc. sponsors the ADHERE registry.

[Study title: Comparison of in-hospital mortality in patients treated with nesiritide vs. other parenteral vasoactive medications for acutely decompensated heart failure: An analysis from a large prospective registry database. Abstract P298]