title: Carperitide Is Associated With Increased In-Hospital Mortality in Acute Heart Failure: A Propensity Score-Matched Analysis.
abstract: BACKGROUND
  Carperitide (α-human A-type natriuretic peptide) has been used for more than one-half of all acute heart failure (AHF) patients in Japan. However, its clinical effectiveness is not well documented.
  
  
  METHODS
  We retrospectively identified AHF patients presenting with acute onset or worsening of symptoms and admitted to 1 of the 3 participating hospitals. Propensity score-matched analysis was performed. The primary end point was in-hospital mortality.
  
  
  RESULTS
  Of all of the AHF patients included in this study, 402 (38.7%) were treated with carperitide, and in-hospital mortality rate for the total cohort was 7.6%. We matched 367 pairs of patients treated with and without carperitide according to propensity score. In this matched cohort, treatment with carperitide was associated with in-hospital mortality (odds ratio [OR] 2.13, 95% confidence interval [CI] 1.17-3.85; P = .013). Potentially more harmful effects were observed in elderly patients (OR 2.93, 95% CI 1.54-5.91).
  
  
  CONCLUSIONS
  Carperitide was significantly associated with increased in-hospital mortality rate in AHF patients. Our results strongly suggest the necessity for well designed randomized clinical trials of carperitide to determine its clinical safety and effectiveness.
authors.affiliation: Department of Cardiology, Kameda Medical Center, Chiba, Japan. Electronic address: yuya8950@gmail.com.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Matsue
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute of Okayama, Okayama, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kagiyama
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Division of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kume
authors.affiliation: First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.affiliation: Department of Cardiology, Kameda Medical Center, Chiba, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Kameda Medical Center, Chiba, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumura
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute of Okayama, Okayama, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Cardiology, Kameda Medical Center, Chiba, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
mesh_terms: D000046:Academic Medical Centers; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D009320:Atrial Natriuretic Factor / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D002423:Cause of Death; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D061214:Patient Safety; D057216:Propensity Score; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric
chemical_list: C472955:NPPA protein, human; D009320:Atrial Natriuretic Factor
keywords: Acute heart failure; drug therapy; prognosis; vasodilator