No Rise in In-Hospital Mortality With Nesiritide

Another analysis focused on patients who received either nesiritide or nitroglycerin as a second drug sometime after the initial 2-hour window that was used to define the IPT. The 1,028 patients who received nesiritide as a second drug (following initial treatment with a diuretic, nitroglycerin, or an inotrope) had an in-hospital mortality rate of 3.4%. By comparison, 1,028 patients who received nitroglycerin as a second drug had a mortality rate of 6.2%, a statistically significant difference.

Data like these are useful, Dr. Costanzo said in an interview, because following publication of the two metaanalyses a year ago, physicians have become more reluctant to prescribe nesiritide to patients with acute decompensated heart failure. “Many physicians have reverted back to using more inotropes, which I'm pretty confident are associated with increased mortality,” she said.