Can BNP-guided therapy improve health-related quality of life, and do responders to BNP-guided heart failure treatment have improved health-related quality of life? Results from the UPSTEP study

BMC Cardiovascular Disorders

Research Article

Ulf Dahlström¹  Urban Alehagen¹  Peter Johansson¹  Patric Karlström²  Kurt Boman³ 

[1] Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden;Department of Medicine, Division of Cardiology, County Hospital Ryhov, Jönköping, Sweden;Research unit Skellefteå Department of Medicine, Institution of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden;

关键词: Heart failure;    Treatment guided by natriuretic peptides;    Health related quality of life;    Responders;    BNP;    SF-36;   

DOI  :  10.1186/s12872-016-0221-7

 received in 2015-10-30, accepted in 2016-02-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundTo investigate whether B-type natriuretic peptide (NP)-guided treatment of heart failure (HF) patients improved their health related quality of life (Hr-QoL) compared to routine HF treatment, and whether changes in Hr-QoL differed depending on whether the patient was a responder to NP-guided therapy or not.MethodsA secondary analysis of the UPSTEP-study, a Scandinavian multicentre study using a prospective, randomized, open, blinded evaluation design on patients with HF with New York Heart Association (NYHA) class II-IV. NP-guiding was aimed to reduce BNP <150 ng/L if < 75 years or BNP < 300 ng/L if > 75 years. A responder was defined as a patient with a BNP < 300 ng/L and/or a decrease in BNP of at least 40 % in week 16 compared to study start. Short form-36 (SF-36) was used to measure Hr-QoL. At the study start, 258 patients presented evaluable SF-36 questionnaires, 131 in the BNP group and 127 in the control group. At the study end 100 patients in the NP-guided group and 98 in the control group, presenting data from both the study start and the study end.ResultsThere were no significant differences in Hr-QoL between NP-guided HF treatment and control group; however significant improvements could be seen in four of the eight domains in the NP-guided group, whereas in the control group improvements could be seen in six of the domains.Among the responders improvements could be noted in four domains whereas in the non-responders improvements could be seen in only one domain evaluating within group changes.ConclusionsImproved Hr-QoL could be demonstrated in several of the domains in both the NP-guided and the control group. In the responder group within group analyses showed more increased Hr-QoL compared to the non-responder group. However, all groups demonstrated increase in Hr-QoL.

【 授权许可】

CC BY   
© Karlström et al. 2016