Efficacy and safety of a modified dosage regimen of nesiritide in patients older than 75 years with acute heart failure.

BACKGROUND AND AIMS: To explore efficacy and safety of a modified dosage regimen of nesiritide in patients (≥75 years) with acute heart failure (AHF). METHODS: Total 140 patients (≥75 years) with AHF were enrolled in this study. They were randomly and evenly divided into two group--control and nesiritide group. The control group received only conventional treatment for AHF, while the nesiritide group received conventional treatment plus a continual intravenous infusion of nesiritide at a rate of 0.0075-0.015 μg·kg(-1)·min(-1) for 10-15 hours (total 0.5- 1.0 mg) once daily for 13 days. RESULTS: Medical research council scales in nesiritide group were significantly lower than those in control group on day 4, 8 and 14. Scores of edema had no significant difference, but were lower in nesiritide group on day 8 and 14. The nesiritide group had markedly more net body fluid losses. NT-proBNP, serum creatinine, blood pressure, cTnI, 30-day and 60-day mortality had no significant difference between two groups. CONCLUSIONS: Nesiritide resulted in improvements in dyspnea and edema, and similar adverse effects compared with conventional treatment. In spite of no reduction on short-term mortality and a reversible influence on renal function, nesiritide was still an important choice for the elderly (≥75 years) with AHF.