Natriuretic peptide-directed medical therapy: a systematic review

dc.contributor.authorAlphonsus, Christella S
dc.contributor.authorGovender, Pooveshnie
dc.contributor.authorRodseth, Reitze N
dc.contributor.authorBiccard, Bruce M
dc.date.accessioned2020-03-02T12:12:09Z
dc.date.available2020-03-02T12:12:09Z
dc.date.issued2020-02-18
dc.date.updated2020-02-23T04:31:52Z
dc.description.abstractAbstract Natriuretic peptides (NP) are strongly associated with perioperative cardiovascular events. However, in patients with raised NP, it remains unknown whether treatment to reduce NP levels prior to surgery results in better perioperative outcomes. In this systematic review and meta-analysis, we investigate NP-directed medical therapy in non-surgical patients to provide guidance for NP-directed medical therapy in surgical patients. The protocol was registered with PROSPERO (CRD42017051468). The database search included MEDLINE (PubMed), CINAHL (EBSCO host), EMBASE (EBSCO host), ProQuest, Web of Science, and Cochrane database. The primary outcome was to determine whether NP-directed medical therapy is effective in reducing NP levels within 6 months, compared to standard of care. The secondary outcome was to determine whether reducing NP levels is associated with decreased mortality. Full texts of 18 trials were reviewed. NP-directed medical therapy showed no significant difference compared to standard care in decreasing NP levels (standardized mean difference − 0.04 (− 0.16, 0.07)), but was associated with a 6-month (relative risk (RR) 0.82 (95% confidence interval (CI) 0.68–0.99)) reduction in mortality.
dc.identifier.apacitationAlphonsus, C. S., Govender, P., Rodseth, R. N., & Biccard, B. M. (2020). Natriuretic peptide-directed medical therapy: a systematic review. http://hdl.handle.net/11427/31441en_ZA
dc.identifier.chicagocitationAlphonsus, Christella S, Pooveshnie Govender, Reitze N Rodseth, and Bruce M Biccard "Natriuretic peptide-directed medical therapy: a systematic review." (2020) http://hdl.handle.net/11427/31441en_ZA
dc.identifier.citationPerioperative Medicine. 2020 Feb 18;9(1):5
dc.identifier.ris TY - AU - Alphonsus, Christella S AU - Govender, Pooveshnie AU - Rodseth, Reitze N AU - Biccard, Bruce M AB - Abstract Natriuretic peptides (NP) are strongly associated with perioperative cardiovascular events. However, in patients with raised NP, it remains unknown whether treatment to reduce NP levels prior to surgery results in better perioperative outcomes. In this systematic review and meta-analysis, we investigate NP-directed medical therapy in non-surgical patients to provide guidance for NP-directed medical therapy in surgical patients. The protocol was registered with PROSPERO (CRD42017051468). The database search included MEDLINE (PubMed), CINAHL (EBSCO host), EMBASE (EBSCO host), ProQuest, Web of Science, and Cochrane database. The primary outcome was to determine whether NP-directed medical therapy is effective in reducing NP levels within 6 months, compared to standard of care. The secondary outcome was to determine whether reducing NP levels is associated with decreased mortality. Full texts of 18 trials were reviewed. NP-directed medical therapy showed no significant difference compared to standard care in decreasing NP levels (standardized mean difference − 0.04 (− 0.16, 0.07)), but was associated with a 6-month (relative risk (RR) 0.82 (95% confidence interval (CI) 0.68–0.99)) reduction in mortality. DA - 2020-02-18 DB - OpenUCT DP - University of Cape Town KW - Cardiac morbidity KW - Pre-operative evaluation KW - Myocardial ischemia LK - https://open.uct.ac.za PY - 2020 T1 - Natriuretic peptide-directed medical therapy: a systematic review TI - Natriuretic peptide-directed medical therapy: a systematic review UR - http://hdl.handle.net/11427/31441 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13741-019-0134-y
dc.identifier.urihttp://hdl.handle.net/11427/31441
dc.identifier.vancouvercitationAlphonsus CS, Govender P, Rodseth RN, Biccard BM. Natriuretic peptide-directed medical therapy: a systematic review. 2020; http://hdl.handle.net/11427/31441.en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.subjectCardiac morbidity
dc.subjectPre-operative evaluation
dc.subjectMyocardial ischemia
dc.titleNatriuretic peptide-directed medical therapy: a systematic review
dc.typeJournal Article
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