Evidence map›Paper›PMID 40464476›Full record

SynthesisClinical cardiology2025

Natriuretic Peptide-Guided Therapy in Acute Decompensated Heart Failure: An Updated Systematic Review and Meta-Analysis.

Luciana Gioli-Pereira, Eric Shih Katsuyama, Christian Ken Fukunaga, Wilson Falco, Camila Campos Grisa Padovese, Rafael Hortencio Melo, Edielle de Sant'Anna Melo, Silvana E Ribeiro Papp, Fernando Bacal

Abstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Luciana Gioli-PereiraDepartment of Cardiology and Intensive Care, Hospital Municipal Dr Gilson de Cássia Marques de Carvalho, Sociedade Beneficente Israelita Brasileira Albert Einstein, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-4682-8095
Eric Shih KatsuyamaDepartment of Medicine, Faculty of Medicine of ABC, Santo André, Brazil.
Christian Ken FukunagaDepartment of Medicine, Faculty of Medicine of ABC, Santo André, Brazil.
Wilson FalcoDepartment of Medicine, Faculdade de Medicina de Catanduva, Catanduva, Brazil.
Camila Campos Grisa PadoveseDepartment of Medicine, Universidade Estadual de Londrina, Londrina, Paraná, Brazil.
Rafael Hortencio MeloDepartment of Cardiology and Intensive Care, Hospital Municipal Dr Gilson de Cássia Marques de Carvalho, Sociedade Beneficente Israelita Brasileira Albert Einstein, São Paulo, Brazil.
Edielle de Sant'Anna MeloDepartment of Cardiology, Hospital Municipal Dr Gilson de Cássia Marques de Carvalho, Sociedade Beneficente Israelita Brasileira Albert Einstein, São Paulo, Brazil.
Silvana E Ribeiro PappUPMC, Harrisburg, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-7785-9265
Fernando BacalDepartment of Cardiology, Sociedade Beneficente Israelita Brasileira Albert Einstein, São Paulo, Brazil.

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

backgroundNatriuretic peptides (NP) are widely used to diagnose heart failure (HF), but their role in guiding treatment remains uncertain. We performed a randomized trial meta-analysis comparing NP-guided therapy to usual care in acute decompensated HF.

methodsWe searched PubMed, Embase, and Cochrane for RCTs comparing NP-guided therapy to usual care in acute decompensated HF. Outcomes included all-cause mortality, cardiovascular death, and a composite of mortality and HF hospitalizations (reported as RR and 95% CI). Heterogeneity was assessed using I

resultsWe included 9 RCTs with 3992 patients, of whom 2007 (50.3%) underwent NP-guided treatment. The median follow-up was 12 months. All-cause mortality (RR: 0.84; 95% CI: 0.69-1.01; p = 0.069; I

conclusionAlthough NP-guided therapy showed a statistically significant benefit in time to all-cause mortality, this was not consistently reflected across other endpoints, and its overall clinical impact remains uncertain.

Indexed as

Heart FailureNatriuretic PeptidesAcute DiseaseBiomarkersGlobal HealthHumansRandomized Controlled Trials as TopicTreatment OutcomeBiomarkersNatriuretic Peptidesheart failurehospitalizationmortalitynatriuretic peptidesusual care

Identifiers

PMID40464476
PMCPMC12135092

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Registered trials

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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.