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Nesiritide May Reduce Mortality and Adverse Events in Heart Failure Patients After Cardiothoracic Surgery: Presented at HFSA
By Bonnie Darves
SEATTLE, WA -- September 14, 2006 -- Patients with heart failure (HF) who receive the drug nesiritide (NES) while undergoing cardiac artery bypass graft (CABG) surgery appear to have significantly reduced mortality rates up to 6 months after the procedure compared with patients on placebo.
Researchers reported these findings, from the phase 2 pilot study of 279 patients, conducted in 54 centres as part of the Nesiritide Administered Peri-Anesthesia in Patient Undergoing Cardiac Surgery (NAPA) trial, at the 10th Annual Scientific Meeting of the Heart Failure Society of America meeting (HFSA) here on September 13th.
Nesiritide, a natriuretic peptide, has been shown in previous studies to reduce the neurohormonal and renal responses and related adverse events associated with CABG, according to study investigator John Luber, Jr., MD, cardiothoracic surgeon, Franciscan Health System Research Center, Tacoma, Washington. The drug is currently approved for the treatment of acute decompensated heart failure.
Patients' mean age was 64 years, and the majority of participants, approximately 78%, were male.
In the study, 30-day mortality rates for the 132 nesiritide-treated patients were approximately half those observed in the placebo group (2.8% vs 5.9 %). The nesiritide group also had fewer cases of renal failure (5% vs 8.5%) and rates of atrial fibrillation were lower as well in the active-treatment group (21.3% vs 31.2%).
Mortality rates at 6 months postsurgery were 6.7% in the nesiritide patients and 14.7% for placebo patients. Length of stay also was slightly lower in the nesiritide-treated patients (9.1 days vs 11.5 days).
This study's results are encouraging given the morbidity of these patients and their high risk for poor outcomes, according to Dr. Luber. Patients are generally critically ill when they undergo surgery "and have limited treatment options," he stated.
The NAPA trial was sponsored by Scios, Inc.
[Presentation title: Perioperative Nesiritide Use Is Associated With Decreased 180-Day Mortality in Heart Failure Patients Undergoing Cardiothoracic Surgery. Poster 235]
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