Intermittent nesiritide therapy in outpatients with chronic heart failure

Abstract

Heart failure (HF) continues to be a significant health problem in the United States. Nearly 550,000 people are diagnosed annually with this condition, and HF is responsible for over 1 million hospitalizations per year.1,2 Despite advances in pharmacologic therapy, a small percentage of patients with severe HF remain refractory to maximum medical therapy. In addition, these patients have high mortality rates, a poor quality of life, and frequent hospitalizations with elevated health care costs. For this subset of patients, some centers in the United States continue to use periodic ino-tropic therapy on an inpatient or outpatient basis under the rationale of reducing symptoms, hospitalizations, and medical costs, even at the risk of increased mortality.

Nesiritide, a human B-type natriuretic peptide, is the first of a new class of agents for the treatment of decompensated HF. In...