1/3/2023 0 Comments Topcat videos![]() ![]() Natriuretic peptide thresholds are often used in trials as a risk enrichment strategy, but this approach may exclude patients in these subsets who truly have HFpEF and who experience high rates of cardiovascular events," Solomon's group said. "Applying a single natriuretic peptide threshold for trial entry may contribute to unbalanced selection and may result in an underrepresentation of certain subgroups. It took a post-hoc study to show that the drug did work in North and South America, however, as it was apparently undermined by a large number of patients enrolled in Russia who never took the study drug.Īdditionally, TOPCAT Americas enrolled almost half of patients based on them meeting a natriuretic peptide threshold, rather than having a history of heart failure hospitalization. Median B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide concentrations were 257 ng/L and 959 ng/L, respectively, in this group.īack in 2013, the main finding from the trial was that spironolactone (Aldactone) was a flop for HFpEF. Their study was based on TOPCAT participants from the Americas region who had left ventricular ejection fractions of ≥45% and available natriuretic peptide measurements (n=1,057). It would be better to have markers that are less sensitive to systematic variation across heterogeneous subsets for use in screening for trials, the investigators emphasized. Estimated glomerular filtration rate ![]() Waist circumference Concentrations varied by up to half a standard deviation in those with: Yet some subgroups started off with higher levels of B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide. ![]()
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