In this single center trial of 364 adults with normal-EF CHF, they were randomized to 3 groups for 2 years: usual care, NT-proBNP-guided care, or intensive clinical assessment-guided care. 1 year mortality was less in the BNP and clinical management groups (9%) than the usual care group (19%). 3 year mortality was less in the BNP group (16%) than the other 2 groups (31%), but only patients <75 years old. BNP guided therapy does not alter short term mortality compared to intensive clinical management. More studies are needed to determine if BNP guided therapy is beneficial, and in what subgroups, but should not currently drive clinical management (abstract).
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