Why the study?
The study aimed to investigate the effects of standard heart failure treatment versus sequential treatment with rhBNP alone or rhBNP followed by sacubitril/valsartan on cardiac structure, pulmonary artery pressure, inflammation, and oxidative stress in acute heart failure.
Does sequential treatment with recombinant human BNP and sacubitril/valsartan improve cardiac structure, pulmonary artery pressure, and biomarkers in patients with acute heart failure?
Comparison
Sequential rhBNP followed by sacubitril/valsartan vs rhBNP alone vs standard treatment
Design
Randomized controlled trial
Follow-up
36 weeks
Key result
Sequential treatment with recombinant human brain natriuretic peptide followed by sacubitril/valsartan significantly improved cardiac structure, pulmonary artery pressure, and biomarkers of myocardial injury compared to standard treatment in patients with acute heart failure.
Authors
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Supports sequential rhBNP then sacubitril/valsartan to augment LVEF recovery in acute HF; extends randomized sequencing data beyond monotherapy.
RCT (n=300)
Random number table method
No
Does sequential treatment with recombinant human BNP and sacubitril/valsartan improve cardiac structure, pulmonary artery pressure, and biomarkers in patients with acute heart failure?
Absolute Event Rate: 14.4% vs 5.29%
p-value: p=<0.05
Sequential treatment with recombinant human BNP followed by sacubitril/valsartan significantly improves cardiac structure, pulmonary artery pressure, and biomarkers of heart failure compared to standard therapy or rhBNP alone.
Pang et al. (2021) conducted an RCT in Acute heart failure (n=300). Sequential treatment with recombinant human brain natriuretic peptide (rhBNP) followed by sacubitril/valsartan vs. Standard treatment (ACEI, beta blocker, mineralocorticoid antagonist) or rhBNP alone was evaluated on Decrease in pulmonary artery pressure at 36 weeks (p=<0.05). Sequential treatment with recombinant human brain natriuretic peptide followed by sacubitril/valsartan significantly improved cardiac structure, pulmonary artery pressure, and biomarkers of myocardial injury compared to standard treatment in patients with acute heart failure.