March 22nd, 2010
• AHA Scientific Statement on Medication Errors in Acute CV Medicine
• BNP-Guided HF Therapy
Larry Husten, PHD
AHA Scientific Statement on Medication Errors in Acute CV Medicine: “Cardiovascular medications are the most common drug class associated with medication errors, and cardiovascular patients remain at high risk in the acute hospital phase, even with the current safety strategies,” said Andrew Michaels, chair of the writing committee for a new AHA scientific statement published in Circulation. According to the statement, by following eight recommendations — from using a simple weight check to using computerized medication orders — healthcare professionals can help reduce medication errors among hospitalized heart and stroke patients.BNP-Guided HF Therapy: Porapakkham et al performed a meta-analysis of randomized controlled trials that tested the use of BNP to guide treatment of heart failure. BNP-guided therapy was associated with a reduction in all-cause mortality, particularly in patients under the age of 75. However, the investigators found no reduction in hospitalizations. The paper appears in Archives of Internal Medicine.
“The additional percentage of patients achieving target doses of angiotensin-converting enzyme inhibitors and β-blockers during the course of these trials averaged 21% and 22% in the BNP group and 11.7% and 12.5% in the control group, respectively.”
The use of ace inhibitors and b-blockers made the difference, not the use of BNP guided outcomes. How can we know so much about treatment of heart failure and still fail with such basic concepts as b-blockers and ace inhibitors. BNP is a useful test but treating with the correct medications works!