Aims: Despite evidence of hemodynamic benefit of sodium nitroprusside (SNP) treatment for acute heart failure (AHF), there are limited data about its efficacy and safety. This study aimed to assess the effectiveness and safety of SNP treatment, to explore the impact of N-terminal pro-B natriuretic peptide (NT-proBNP) reduction on clinical endpoints and to identify possible predictors of clinical response. Methods and results: Multicenter retrospective cohort study of 200 patients consecutively admitted for AHF in 2 Italian Centers. Primary endpoint was the reduction of NT-proBNP levels ≥25% from baseline values within 48 h from the onset of SNP infusion. Secondary and safety endpoints included all-cause mortality, rehospitalization for HF at 1, 3 and 6 months, length of hospital stay (LOS) and severe hypotension. 131 (66%) patients experienced a NT-proBNP reduction ≥25% within 48 h from treatment onset, irrespective of initial systolic blood pressure (SBP). Left ventricular end diastolic diameter (LVEDD) was the only independent predictor of treatment efficacy. Patients who achieved the primary endpoint (i.e., ‘responders’) had lower LOS (median 15 [IQR:10–27] vs 19 [IQR:12–35] days, p-value = 0.033) and a lower incidence of all-cause mortality and rehospitalization for HF at 1 and 3 months compared to “non responders” (p-value <0.050). Severe hypotension was observed in 10 (5%) patients, without any adverse clinical consequence. Conclusion: SNP is a safe and effective treatment of AHF, particularly in patients with dilated left ventricle. Reduced NT-proBNP levels in response to SNP is associated to shorter LOS and lower risk of 1- and 3-month re-hospitalizations for HF. Clinical trial registration. http://www.clinicaltrials.gov. Unique identifier: NCT05027360

Garatti, L., Frea, S., Bocchino, P., Angelini, F., Cingolani, M., Sacco, A., et al. (2022). Sodium nitroprusside in acute heart failure: A multicenter historic cohort study. INTERNATIONAL JOURNAL OF CARDIOLOGY, 369(15 December 2022), 37-44 [10.1016/j.ijcard.2022.08.009].

Sodium nitroprusside in acute heart failure: A multicenter historic cohort study

Bagnardi V.;Sala I. M.;
2022

Abstract

Aims: Despite evidence of hemodynamic benefit of sodium nitroprusside (SNP) treatment for acute heart failure (AHF), there are limited data about its efficacy and safety. This study aimed to assess the effectiveness and safety of SNP treatment, to explore the impact of N-terminal pro-B natriuretic peptide (NT-proBNP) reduction on clinical endpoints and to identify possible predictors of clinical response. Methods and results: Multicenter retrospective cohort study of 200 patients consecutively admitted for AHF in 2 Italian Centers. Primary endpoint was the reduction of NT-proBNP levels ≥25% from baseline values within 48 h from the onset of SNP infusion. Secondary and safety endpoints included all-cause mortality, rehospitalization for HF at 1, 3 and 6 months, length of hospital stay (LOS) and severe hypotension. 131 (66%) patients experienced a NT-proBNP reduction ≥25% within 48 h from treatment onset, irrespective of initial systolic blood pressure (SBP). Left ventricular end diastolic diameter (LVEDD) was the only independent predictor of treatment efficacy. Patients who achieved the primary endpoint (i.e., ‘responders’) had lower LOS (median 15 [IQR:10–27] vs 19 [IQR:12–35] days, p-value = 0.033) and a lower incidence of all-cause mortality and rehospitalization for HF at 1 and 3 months compared to “non responders” (p-value <0.050). Severe hypotension was observed in 10 (5%) patients, without any adverse clinical consequence. Conclusion: SNP is a safe and effective treatment of AHF, particularly in patients with dilated left ventricle. Reduced NT-proBNP levels in response to SNP is associated to shorter LOS and lower risk of 1- and 3-month re-hospitalizations for HF. Clinical trial registration. http://www.clinicaltrials.gov. Unique identifier: NCT05027360
Articolo in rivista - Articolo scientifico
Acute heart failure; NT-proBNP; Sodium nitroprusside; Vasodilators;
English
6-ago-2022
2022
369
15 December 2022
37
44
none
Garatti, L., Frea, S., Bocchino, P., Angelini, F., Cingolani, M., Sacco, A., et al. (2022). Sodium nitroprusside in acute heart failure: A multicenter historic cohort study. INTERNATIONAL JOURNAL OF CARDIOLOGY, 369(15 December 2022), 37-44 [10.1016/j.ijcard.2022.08.009].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/398242
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