EffectofNesiritideinPatientswithAcuteDecompensatedHeartFailurePresentedbyDrWangPUMCO'ConnorCM,StarlingRC,HernandezAF,ArmstrongPW,DicksteinK,HasselbladV,HeizerGM,KomajdaM,MassieBM,McMurrayJJ,NieminenMS,ReistCJ,RouleauJL,SwedbergK,AdamsKFJr,AnkerSD,AtarD,BattlerA,BoteroR,BohidarNR,ButlerJ,ClausellN,CorbalánR,CostanzoMR,DahlstromU,DeckelbaumLI,DiazR,DunlapME,EzekowitzJA,FeldmanD,FelkerGM,FonarowGC,GennevoisD,GottliebSS,HillJA,HollanderJE,HowlettJG,HudsonMP,KociolRD,KrumH,LauceviciusA,LevyWC,MéndezGF,MetraM,MittalS,OhBH,PereiraNL,PonikowskiP,TangWH,TanomsupS,TeerlinkJR,TriposkiadisF,TroughtonRW,VoorsAA,WhellanDJ,ZannadF,CaliffRM.NEnglJMed.2011Jul7;365(1):32-43Introduction•Treatacuteheartfaluire•Approvedin2001byFDAO'Connor,NEnglJMed.2011Jul7;365(1):33Picturefrom•Improvementinheartfunctionandreliefindifficultbreathing•WorsenrenalfunctionandincreasedeathrateO'Connor,NEnglJMed.2011Jul7;365(1):33Picturefrom://•Randomized,double-blind,placebo-controlledtrial•FromMay2007throughAugust2010at398centers•WritteninformedconsentO'Connor,NEnglJMed.2011Jul7;365(1):33StudypatientKeyinclusioncriteriae.g.,Hospitalizedforheartfailurewithin24hoursDifficultbreathingatrestKeyexclusioncriteriae.g.,HighriskoflowbloodpressureO'Connor,NEnglJMed.2011Jul7;365(1):34EndPoints•Changeinself-reporteddyspnea6and24hoursafterstudy-druginitiation•Rehospitalizationforheartfailureanddeathfromrandomizationtoday30O'Connor,NEnglJMed.2011Jul7;365(1):34Statisticalanalysis•EstimatedinCochran–MantelHaenszel(CMH)test•Pvalue≤0.005O'Connor,NEnglJMed.2011Jul7;365(1):34Results•7141patients•NorthAmerica,Europe,LatinAmerica,andtheAsia–PacificregionO'Connor,NEnglJMed.2011Jul7;365(1):33Picturefrom(1):36,Table1Figure1A.ChangesinDyspneaat6and24HoursO'Connor,NEnglJMed.2011Jul7;365(1):38,Figure1AFigure1B.Primaryclinicalendpointsat30DaysO'Connor,NEnglJMed.2011Jul7;365(1):38,Figure1BConclusions•Noimprovementinpatientswithacuteheartfailure•Nochangeintherateofdeathandrehospitalization•NolongerberecommendedO'Connor,NEnglJMed.2011Jul7;365(1):42Limitations•Studypopulation•Evaluationofdyspnea•Lowerclinical-eventrateO'Connor,NEnglJMed.2011Jul7;365(1):42AcknowlegementsThisstudywassupportedbyScios.O'Connor,NEnglJMed.2011Jul7;365(1):42