Nipping Heart Failure Complications

Protein therapy reduces heart failure related hospitalizations

(RxWiki News) It's been suggested that blood levels of a protein decline after beginning treatment for heart failure. Using medications to force it to drop if it doesn't happen on its own can reduce hospitalizations and cardiovascular complications.

Adding routine blood tests to check for the protein, a cardiac distress biomarker, and ensure it remains below 1,000 pg/mL can reduce the number of heart failure hospitalizations by half. Study results were so powerful that the research was halted halfway through the planned research.

"Ask your cardiologist about the latest heart failure treatments."

Dr. James Januzzi Jr., study author, a doctor with the Massachusetts General Hospital's cardiology division and an associate professor of medicine at Harvard Medical School, said the findings represent a turning point in understanding of biomarker-guided care for heart failure. He said that the major lesson learned was that setting and achieving low NT-proBNP goals is essential. When those goals are met, he said, it can result in substantial improvements in outcomes.

Their research suggested that in addition to a significant reduction in hospitalizations, controlling the protein level can lower the incidences of arrhythmias, stroke, heart attack and cardiac death.

During the PROTECT study, researchers studied 151 patients with dysfunction of the heart's left ventricle over a four-year period. The goal of the study was to reduce NT-proBNP levels from an average of more than 2,000 pg/mL in untreated patients to below 1,000 pg/mL.

Participants received standard treatment for heart failure, including blood pressure and heart rate monitoring used to guide medication dosage. In half of the patients NT-proBNP blood levels also were monitored and medications were given to aid patients in reaching the NT-proBNP target.

Investigators found that the rates of worsening heart failure symptoms and hospitalizations was reduced by half in the group whose care was guided by NT-proBNP measurements. That group also reported significantly better quality of life and were shown by echocardiography to have greater improvement in the structure and function of the heart muscle.

Dr. Januzzi said the study is currently being replicated in a larger multi-center trial. He said that if that trial confirms these findings, this approach could lead to improved cardiac function and better patient quality of life. It also could reduce health expenditures.

The article will be published in the Oct. 25 issue of the Journal of the American College of Cardiology.

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Review Date: 
October 21, 2011