Evidence map›Paper›PMID 21732835›Full record

Trial reportThe New England journal of medicine2011

Effect of nesiritide in patients with acute decompensated heart failure.

C M O'Connor, R C Starling, A F Hernandez, P W Armstrong, K Dickstein, V Hasselblad, G M Heizer, M Komajda, B M Massie, J J V McMurray and 48 more

Erratum issued 4 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 4 registered trials, which are not on this map. Cited by 444 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
444citing papers in PubMed, 15 pooled it
73.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04298229 phase3completedstarted 2020, after this paper: background citation

A Randomized, Open-label Study of Dapagliflozin in Patients With or Without Type 2 Diabetes Admitted With Acute Heart Failure

Ran2020Enrolled240Registered outcomes3Posted comparisons0ConditionsDiabetes Mellitus, Type 2, Heart FailureArmsDapagliflozin 10 mg, Protocolized Diuretic Therapy
PMID 27266853PMID 26299229PMID 26041600PMID 25838436PMID 25287144PMID 24879974PMID 24585267PMID 24379278PMID 24247300PMID 23356556PMID 23333145PMID 23141816other papers from this trial
Open the trial in the graph
NCT00475852 phase3completednot on this map

Double-Blind, Placebo-Controlled, Multicenter Acute Study of Clinical Effectiveness of Nesiritide in Subjects With Decompensated Heart Failure (ASCEND-HF)

TypeinterventionalSponsorScios, Inc.Ran2007 to 2011Enrolled7,141ConditionsHeart DecompensationArmsNesiritide, Placebo
NCT02742909 phase4completednot on this mapstarted 2015, after this paper: background citation

Acute Effect of Recombinant Human Brain Natriuretic Peptide in Patients With Pulmonary Hypertension Associated With Acute Exacerbation of Chronic Pulmonary Disease

TypeinterventionalSponsorLI ZHAORan2015 to 2018Enrolled9ConditionsPulmonary HypertensionArmsrhBNP, placebo
NCT07617675 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Perioperative Recombinant Human Brain Natriuretic Peptide for Renal Protection in Cardiac Surgery: the PROTECT-CS Randomized Clinical Trial

TypeinterventionalSponsorChina National Center for Cardiovascular DiseasesRan2026 to 2029Enrolled694ConditionsAKI - Acute Kidney Injury, Cardiac Surgical Procedures, Cardiopulmonary BypassArmsRecombinant Human Brain Natriuretic Peptide (rhBNP), Normal Saline (Placebo)
3 · Its place in the literature

Who cites it

444 citing papers in PubMed, 15 syntheses or guidelines pooled it, 1,228 citations in OpenAlex.

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  7. Common Variants onCirculation. Heart failure · 2023
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  13. Angiotensin-converting-enzyme inhibitors in hemodynamic congestion: a meta-analysis of early studies.Clinical research in cardiology : official journal of the German Cardiac Society · 2019
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  20. [A nomogram based on systemic inflammation markers can predict adverse outcomes in patients with heart failure].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2022
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384 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

58 authors at 1 institution in 1 country.

C M O'ConnorDuke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27710, USA. oconn002@mc.duke.edu
R C Starling
A F Hernandez
P W Armstrong
K Dickstein
V Hasselblad
G M Heizer
M Komajda
B M Massie
J J V McMurray
M S Nieminen
C J Reist
J L Rouleau
K Swedberg
K F Adams
S D Anker
D Atar
A Battler
R Botero
N R Bohidar
J Butler
N Clausell
R Corbalán
M R Costanzo
U Dahlstrom
L I Deckelbaum
R Diaz
M E Dunlap
J A Ezekowitz
D Feldman
G M Felker
G C Fonarow
D Gennevois
S S Gottlieb
J A Hill
J E Hollander
J G Howlett
M P Hudson
R D Kociol
H Krum
A Laucevicius
W C Levy
G F Méndez
M Metra
S Mittal
B-H Oh
N L Pereira
P Ponikowski
W H W Tang
W H Wilson
S Tanomsup
J R Teerlink
F Triposkiadis
R W Troughton
A A Voors
D J Whellan
F Zannad
R M Califf
Duke Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent.

methodsWe randomly assigned 7141 patients who were hospitalized with acute heart failure to receive either nesiritide or placebo for 24 to 168 hours in addition to standard care. Coprimary end points were the change in dyspnea at 6 and 24 hours, as measured on a 7-point Likert scale, and the composite end point of rehospitalization for heart failure or death within 30 days.

resultsPatients randomly assigned to nesiritide, as compared with those assigned to placebo, more frequently reported markedly or moderately improved dyspnea at 6 hours (44.5% vs. 42.1%, P=0.03) and 24 hours (68.2% vs. 66.1%, P=0.007), but the prespecified level for significance (P≤0.005 for both assessments or P≤0.0025 for either) was not met. The rate of rehospitalization for heart failure or death from any cause within 30 days was 9.4% in the nesiritide group versus 10.1% in the placebo group (absolute difference, -0.7 percentage points; 95% confidence interval [CI], -2.1 to 0.7; P=0.31). There were no significant differences in rates of death from any cause at 30 days (3.6% with nesiritide vs. 4.0% with placebo; absolute difference, -0.4 percentage points; 95% CI, -1.3 to 0.5) or rates of worsening renal function, defined by more than a 25% decrease in the estimated glomerular filtration rate (31.4% vs. 29.5%; odds ratio, 1.09; 95% CI, 0.98 to 1.21; P=0.11).

conclusionsNesiritide was not associated with an increase or a decrease in the rate of death and rehospitalization and had a small, nonsignificant effect on dyspnea when used in combination with other therapies. It was not associated with a worsening of renal function, but it was associated with an increase in rates of hypotension. On the basis of these results, nesiritide cannot be recommended for routine use in the broad population of patients with acute heart failure. (Funded by Scios; ClinicalTrials.gov number, NCT00475852.).

Indexed as

Acute DiseaseAgedDouble-Blind MethodDyspneaFemaleHeart FailureHumansHypotensionIntention to Treat AnalysisKidney DiseasesMaleMiddle AgedNatriuretic AgentsNatriuretic Peptide, BrainPatient ReadmissionRecurrenceNatriuretic AgentsNatriuretic Peptide, Brain

Identifiers

PMID21732835
OpenAlexW2069722675

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.