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VIDEO: Expert discusses outcomes, implications of PRIMA II study
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ORLANDO, Fla. — In this video exclusive, James L. Januzzi Jr., MD, provides perspective on new research on the use of N-terminal pro B-type natriuretic peptide-guided therapy in patients with acute decompensated HF.
Data from the PRIMA II study were presented during a late-breaking clinical trial session at the Heart Failure Society of America Scientific Assembly. The international, multicenter, randomized trial was designed to examine whether NT-proBNP-guided therapy during hospital admission for acute decompensated HF can reduce mortality and readmissions.
Although 19% more patients assigned an intensified-management approach had a reduction in NT-proBNP of 30% compared with patients assigned usual care, outcomes were not different between the two groups.
Discussing the trial with Cardiology Today, Januzzi said limitations of the trial were that it was “greatly underpowered” and compared “small numbers of patients.” However, “one of the most important takeaways, is if you look at all of the patients relative to their admission NT-proBNP, if a reduction of 30% was achieved, either by the day 3 mark or overall by the end of hospitalization, there were far superior outcomes compared to those patients not achieving the 30% reduction,” Januzzi, the Roman W. DeSanctis Endowed Distinguished Clinical Scholar in Medicine and director of the Dennis and Marilyn Barry Fellowship in Cardiology Research at Massachusetts General Hospital, said.
The answer as to whether NT-proBNP-guided therapy in this population can reduce mortality and readmissions remains unanswered, according to Januzzi. “We are left with more questions than answers right now, but it still confirms the value of NT-proBNP monitoring for prognostication in acute [decompensated] HF,” he said.