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.
Fill in the Blanks: Q: “The diagnosis of type 2 MI is associated with a _____ prognosis. ___% of patients will live five years after their diagnosis.” The answer is a) POOR and b) a staggering 40%. I did not know that. However, what I am aware of is the ambiguity around Type 2 MIs and […]
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]