In this multicenter trial of 500 patients >age 60, patients were randomized to CHF medical titration based on symptoms alone (goal NYHA class <2), or symptoms + BNP (goal of <2 times upper limit of normal). There was no difference in 18 month quality of life, overall survival, or survival free hospitalizations, but the BNP-guided group did have fewer CHF hospitalizations (62% vs 72%) (only found in those <age 75) (abstract). An editorialist advocates using BNP to titrate CHF medications in patients <75 years old (editorialist). Although this was an outpatient study, this data give some credence to the common practice of using BNP measurements to gauge CHF treatment success in the inpatient setting.
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