Controversy and conflict in the treatment of acute decompensated heart failure: nesiritide as evidence-based treatment.
Acute decompensated heart failure poses a complex clinical challenge for the health care community. Evolving concepts of the pathophysiology and lack of consensus on appropriate outcome measures for drug approval underlie some of the current controversies about nesiritide. We outline the major controversies from the viewpoint that nesiritide should continue to be used judiciously by following its package insert recommendations and the Heart Failure Society of America's 2006 Comprehensive Heart Failure Practice Guidelines.
Munger
Mark A
MA
Department of Pharmacotherapy and Internal Medicine, University of Utah, Salt Lake City, Utah 84112, USA. mmunger@hsc.utah.edu
Ng
Tien M H
TM
Van Tassell
Benjamin W
BW
D000208:Acute Disease; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D045283:Natriuretic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care / Q000379:methods; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D051437:Renal Insufficiency
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain