Heart, lung & circulation
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Heart, lung & circulation · Oct 2013
Review Meta AnalysisB-type natriuretic peptide-guided chronic heart failure therapy: a meta-analysis of 11 randomised controlled trials.
The use of plasma levels of B-type natriuretic peptides (BNPs) to guide treatment of patients with chronic heart failure (HF) has been investigated in a number of randomised controlled trials (RCTs). However, the benefits have been variable. We therefore performed a meta-analysis to examine the overall effect of BNP-guided drug therapy on all-cause mortality and HF rehospitalisation in patients with chronic HF. ⋯ Compared with usual clinical care, B-type natriuretic peptide-guided therapy reduces all-cause mortality and HF rehospitalisation, especially in patients younger than 70 years or with higher baseline BNP.
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Heart, lung & circulation · Oct 2013
Comparative Study Clinical TrialComparison of three risk stratification rules for predicting patients with acute coronary syndrome presenting to an Australian emergency department.
To compare the predictive ability of three risk stratification tools used to assess patients presenting to the ED with potential acute coronary syndrome. ⋯ All three scores were similar in performance in quantifying risk in ED patients with possible ACS. The GRACE score identified a sizable low risk cohort with high sensitivity and NPV but complexity of this tool may limit its utility. Improved scores are needed to allow early identification of low- and high-risk patients to support improvements in patient flow and ED overcrowding.