title: Acute study of clinical effectiveness of nesiritide in decompensated heart failure: nesiritide redux.
abstract: Nesiritide, a synthetic drug form of human B-type natriuretic peptide, is approved for the early treatment of dyspnea in acute decompensated heart failure. Meta-analyses suggested a risk of worsening renal insufficiency and mortality with its use. Therefore, the Acute Study of Clinical Effectiveness in Decompensated Heart Failure (ASCEND-HF) was designed as a prospective, multicenter, double-blind, randomized trial to examine the use of nesiritide in this common, morbid, and often lethal clinical condition. Two coprimary end points, dyspnea and 30-day hospital readmission or death, were chosen to examine symptomatic response and objective outcomes, respectively. Preliminary reports from ASCEND-HF investigators suggest no significant improvement in symptoms or clinical outcomes, although no adverse effect on mortality or renal function was noted. We recommend the continued use of nesiritide in acute decompensated heart failure as an individualized case-based therapy to those patients who meet criteria for treatment and are expected to receive benefit from its use.
authors.affiliation: Division of Cardiovascular Medicine, The Ohio State University Medical Center, Columbus, OH 43210, USA. adam.pleister@osumc.edu
authors.forename: Adam P
authors.initials: AP
authors.lastname: Pleister
authors.forename: Ragavendra R
authors.initials: RR
authors.lastname: Baliga
authors.forename: Garrie J
authors.initials: GJ
authors.lastname: Haas
mesh_terms: D000328:Adult; D017326:Clinical Trials, Phase III as Topic; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D045283:Natriuretic Agents / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use*; D018579:Patient Selection; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016896:Treatment Outcome
chemical_list: D045283:Natriuretic Agents; D010919:Placebos; D020097:Natriuretic Peptide, Brain