LASCAR-AHF
Trial question
What is the effect of low-dose carperitide, a recombinant atrial natriuretic peptide, in patients with acute HF?
Study design
Multi-center
Open label
RCT
Population
247 patients.
Inclusion criteria: patients with acute HF.
Key exclusion criteria: no indication of intravenous vasodilators or diuretics for initial treatment; carperitide administration before randomization; eGFR < 15 mL/min/1.73 m²; receipt of dialysis; acute coronary syndrome; pregnancy.
Interventions
N=122 carperitide (at a dose of 0.02 mcg/kg/min plus standard treatment at 72 hours).
N=125 standard treatment (standard treatment for 72 hours).
Primary outcome
Death or heart failure hospitalization at 2 years
29.5%
28%
29.5 %
22.1 %
14.8 %
7.4 %
0.0 %
Carperitide
Standard
treatment
No significant
difference ↔
No significant difference in death or HF hospitalization at 2 years (29.5% vs. 28%; HR 1.26, 95% CI 0.78 to 2.06).
Secondary outcomes
No significant difference in cumulative urine volume at 72 hours (5477 mL vs. 5499 mL; AD 206 mL, 95% CI -405 to 817).
No significant difference in reduction in BNP at 72 hours (333 pg/mL vs. 348 pg/mL; AD -30.2 pg/mL, 95% CI -100 to 40.1).
Significantly greater reduction in eGFR at 72 hours (5.42 mL/min/1.73 m² vs. 1.34 mL/min/1.73 m²; AD 3.88 mL/min/1.73 m², 95% CI 0.76 to 7).
Conclusion
In patients with acute HF, carperitide was not superior to standard treatment with respect to death or HF hospitalization at 2 years.
Reference
Satoshi Honda, Toshiyuki Nagai, Yasuyuki Honda et al. Effect of Low-dose Administration of Carperitide for Acute Heart Failure: the LASCAR-AHF trial. Eur Heart J Acute Cardiovasc Care. 2024 Dec 4:zuae140. Online ahead of print.
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