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: Yuya Matsue, Nobuyuki Kagiyama, Kazuki Yoshida, Teruyoshi Kume, Hiroyuki Okura, Makoto Suzuki, Akihiko Matsumura, Kiyoshi Yoshida, Yuji Hashimoto
• Journal: Journal of cardiac failure (J Card Fail) Vol. 21 Issue 11 Pg. 859-64 (Nov 2015) ISSN: 1532-8414 [Electronic] United States
• PMID: 25999241 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• NPPA protein, human
• Atrial Natriuretic Factor

Topics

• Academic Medical Centers
• Acute Disease
• Aged
• Aged, 80 and over
• Area Under Curve
• Atrial Natriuretic Factor (adverse effects, therapeutic use)
• Case-Control Studies
• Cause of Death
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Heart Failure (diagnosis, drug therapy, mortality)
• Hospital Mortality (trends)
• Humans
• Incidence
• Japan
• Male
• Patient Safety
• Propensity Score
• Reference Values
• Retrospective Studies
• Risk Assessment
• Statistics, Nonparametric