Congestive Heart Failure Clinical Trial
Official title:
BNP Therapy Observation Unit Outcomes STudy
The investigators hypothesize that patients admitted to an emergency department (ED) observation unit will have a decreased rate of hospital admissions and ED recidivism when treated with nesiritide versus standard therapy. The investigators also hypothesize that decreasing B-type Natriuretic Peptide (BNP) levels during treatment in an ED observation unit will predict improved patient outcomes.
Congestive heart failure (CHF) is a growing problem in the United States. The increasing
number of decompensated heart failure patients presenting to emergency departments (ED) for
treatment is worsening the burden on already strained and limited health care resources. In
addition, many of these patients will return to the ED for treatment within three months of
being treated for decompensated heart failure. The emergence of ED observation units has
provided a viable and cost effective alternative to inpatient treatment for many diseases
including CHF. It has been shown that intensive, directed therapy in ED observation units
has decreased the revisit rates for CHF patients. In addition, the introduction of
nesiritide has shown promising results in the treatment of decompensated congestive heart
failure.
The primary aim of this study is to compare nesiritide versus standard heart failure therapy
in an ED setting. A secondary aim is to determine if serial BNP levels during this
observation unit stay will predict clinical outcomes.
The treatment of heart failure in the ED places a tremendous burden on already limited
resources. The costs of treatment as well as the morbidity and mortality associated with the
disease are worsening and are predicted to increase as the general population ages. The
ability to safely treat and discharge patients from an ED observation unit while reducing
return visits would be invaluable in managing the growing number of heart failure patients.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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