title: Multicenter prospective investigation on efficacy and safety of carperitide as a first-line drug for acute heart failure syndrome with preserved blood pressure: COMPASS: Carperitide Effects Observed Through Monitoring Dyspnea in Acute Decompensated Heart Failure Study.
abstract: BACKGROUND
  Recently, vasodilators have been increasingly being recognized as useful for the treatment of acute heart failure syndromes (AHFS). Although carperitide (alpha-human atrial natriuretic peptide) has vasodilatory, diuretic and organ-protective effects, its efficacy and safety for the first-line drug treatment of AHFS have not been reported.
  
  
  RESULTS
  A prospective observational study was performed in AHFS patients with preserved systolic blood pressure (SBP >or=120 mmHg), pulmonary congestion and dyspnea who were receiving carperitide monotherapy. The analysis was conducted in 1,832 patients (male: 52.7%; mean age: 75.1+/-12.7 years). The initial SBP was 151.1+/-25.7 mmHg; 62.0% were diagnosed as having acutely decompensated chronic heart failure and 78.8% were assessed as functional class III-IV according to New York Heart Association classification. Carperitide was administered at an initial dosage of 0.025-0.05 microg x kg(-1) x min(-1) in 50.4% of patients. In 1,524 patients (83.2%), carperitide monotherapy restored the acute phase and improved the degree of dyspnea as assessed using the modified Borg scale. The incidence of adverse drug reactions was 4.64%; the most frequently reported adverse reaction was hypotension (3.55%).
  
  
  CONCLUSIONS
  In the present study, following carperitide monotherapy, 83.2% of AHFS patients recovered from the acute phase. Based on these findings, carperitide seems useful for the first-line drug treatment of AHFS in patients with pulmonary congestion and preserved blood pressure.
authors.affiliation: Marketing Department, Marketing and Sales Division, Daiichi-Sankyo Company Limited, Chuo-ku, Tokyo, Japan. nomura.fumihiro.su@daiichisankyo.co.jp
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Nomura
authors.forename: Nobushige
authors.initials: N
authors.lastname: Kurobe
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Mori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hikita
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawai
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Suwa
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Okutani
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D004417:Dyspnea / Q000188:drug therapy; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: C472955:NPPA protein, human; D014665:Vasodilator Agents; D009320:Atrial Natriuretic Factor