Effect of carperitide on in-hospital mortality of patients admitted for heart failure: propensity score analyses

Abstract

Although a previous randomized study showed that the use of atrial natriuretic peptide (carperitide) improved the long-term prognosis of patients with heart failure, its effect on short-term prognosis remains unclear. We retrospectively identified patients who were admitted to our tertiary-care center with acute decompensated heart failure (ADHF) between April 2009 and December 2013.We divided the eligible patients into two groups: patients who started receiving carperitide on the day of admission (carperitide group) and those who did not receive carperitide during hospitalization (control group). We compared the in-hospital mortality between the two groups using propensity scores derived from 40 baseline variables. We identified 879 eligible patients (mean age, 75.2 years; male, 56.7%), including 336 (38.2%) in the carperitide group and 543 (61.8%) in the control group. One-to-one propensity score matching created 177 pairs. Although the unmatched analysis found a significantly lower in-hospital mortality in the carperitide group than in the control group (3.3% vs. 7.9%, respectively, p = 0.005), the propensity score-matched analysis found no significant difference in in-hospital mortality between the two groups [4.0% vs. 5.1%, p = 0.609; risk difference, -1.1%, 95% confidence interval (CI), -5.5-3.2%]. Logistic regression analysis with adjustment for propensity scores also found no significant association between carperitide use and in-hospital mortality (adjusted odds ratio, 0.61; 95% CI, 0.29 to 1.28; p = 0.605). The present retrospective study showed that carperitide use as the initial treatment was not significantly associated with lower in-hospital mortality in patients with ADHF.

DNA Methylation of the Natriuretic Peptide System Genes and Ischemic Stroke

“…[1][2][3] These hormones have been demonstrated to be useful predictors for risks of stroke 4,5 and other cardiovascular diseases (CVD) [6][7][8] in various populations. Admittedly, some drugs based on the NP system, e.g., carperitide, have been produced and used in clinical settings to treat acute heart failure, 9,10 but could cause some unfavorable side reactions, e.g., severe hypotension [10][11][12] and in-hospital death. [13][14][15] Furthermore, the clinical translation of the NP system to stroke, a main constituent of CVD, is also limited.…”

Burden of Repeated Hospitalizations on Patients with Heart Failure: An Analysis of Administrative and Claims Data in Japan

“…Of note, the efficacy of short-term treatment with carperitide has not been widely validated for HF. In previous Japanese studies, this drug was not associated with lower in-hospital mortality rates, and patients who had a poor response to this drug showed poor prognosis and worsening of HF [40][41][42]. Thus, initial vasodilator drug choices must be carefully considered in order to avoid potential increases in healthcare costs.…”

Association between NPPA promoter methylation and hypertension: results from Gusu cohort and replication in an independent sample

“…As one of the main components of the natriuretic peptides system, ANP has been widely considered a potential drug candidate for the cardiovascular system due to its biological functions of natriuresis, diuresis, vasorelaxation, and inhibition of renin and aldosterone secretion [ 32 ]. The recombinant ANP carperitide has been used in clinical practice for the management of acute decompensated heart failure [ 23 , 24 ] but could cause some unfavorable effects, e.g., severe hypotension [ 24 – 26 ] and in-hospital death [ 27 – 29 ]. A better understanding of the molecular mechanisms underlying the association between ANP and hypertension may help its drug development and improvement.…”