Daily home BNP monitoring in heart failure for prediction of impending clinical deterioration: results from the HOME HF study

European Journal of Heart Failure
Kenneth McDonaldRobert Doughty

Abstract

Serial measurement of natriuretic peptides may guide management in heart failure (HF) patients. In previous trials, natriuretic peptides were infrequently monitored, which may undervalue the benefit of this approach. HOME was an adaptive three-arm randomized clinical study to test whether home monitoring of BNP could reduce HF-related death, hospitalization due to acute decompensated HF (ADHF), and ADHF treated with intravenous diuretics in the emergency department or outpatient setting. Enrolment was terminated early because of slow enrolment, low event rates, and the belief that an algorithm for assessing BNP trends was needed. Justification for pooling data from all study arms was made and analysis as a single observational study was performed. The analysis resulted in 107 patients who were monitored for a median of 172 days with BNP measures on a median of 74% of days. BNP values were highly variable within a patient. Dispersion between serial BNPs was calculated to be 39.3%, 57.7%, and 73.6% for 1, 60, and 120 days between measures, respectively. A moving average filter (fBNP) was calculated to reduce day-to-day fluctuations and track changes from week to week. There were 27 primary events in 17 362 patient days of monitor...Continue Reading

References

May 30, 2002·European Journal of Heart Failure·Gad CotterEdo Kaluski
Sep 12, 2007·Circulation·Sarwat I ChaudhryHarlan M Krumholz
Sep 2, 2008·European Journal of Heart Failure·Alan MaiselEugene Braunwald
Feb 15, 2011·Lancet·William T AbrahamUNKNOWN CHAMPION Trial Study Group
Mar 19, 2013·Journal of the American College of Cardiology·Alan MaiselBarry Greenberg
Apr 12, 2014·JACC. Heart Failure·Gianluigi SavaresePasquale Perrone-Filardi
Oct 22, 2016·European Journal of Heart Failure·Wouter C MeijersRudolf A de Boer
Dec 3, 2016·Journal of the American College of Cardiology·Michael R ZileScott D Solomon

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Citations

Jan 13, 2018·European Journal of Heart Failure·Serge Masson, Roberto Latini
Jan 12, 2019·Current Opinion in Cardiology·Nicholas Wettersten, Alan S Maisel
Jun 22, 2019·European Journal of Heart Failure·Christian MuellerUNKNOWN Heart Failure Association of the European Society of Cardiology
Apr 28, 2020·Heart Failure Reviews·A FaragliAlessio Alogna
Jan 8, 2020·European Heart Journal Supplements : Journal of the European Society of Cardiology·Giuseppe M C RosanoCristiana Vitale
Jan 31, 2020·ESC Heart Failure·Daniela TomasoniMarco Metra
Dec 6, 2020·ESC Heart Failure·Daniela TomasoniMarco Metra
Jul 17, 2021·Cardiovascular Drugs and Therapy·Kai WangLu-Yu Zhou

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