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Dr. Grey AI

Peptide

Nesiritide (Natrecor)

Nesiritide is a recombinant form of human B-type natriuretic peptide (BNP). FDA-approved in 2001 for acute decompensated heart failure (ADHF). Clinical trials in >2000 patients demonstrated rapid hemodynamic improvement and dyspnea relief. The VMAC trial showed superiority over nitroglycerin for dyspnea improvement. Administered as IV bolus followed by continuous infusion.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
1
Outcomes
12
Graded outcomes
4422

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

1 condition, plus general outcomes

Heart Failure

Heart Failure: outcomes studied for Nesiritide (Natrecor)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Pulmonary Capillary Wedge Pressure

Significant and sustained reduction in PCWP. VMAC trial showed greater PCWP reduction vs nitroglycerin at 3 hours (P=0.03).

Improves (the measure goes down)Large effect15 studies

Studies that measured pulmonary capillary wedge pressure

and 5 more in the citations list

Dyspnea Improvement

VMAC trial: Greater improvement in dyspnea vs nitroglycerin at 3 hours. Rapid onset symptomatic relief in ADHF.

Improves (the measure goes up)Large effect15 studies

Studies that measured dyspnea improvement

and 5 more in the citations list

Systemic Vascular Resistance

Balanced vasodilation with sustained SVR reduction without tachyphylaxis observed in clinical trials.

Improves (the measure goes down)Moderate effect15 studies

Studies that measured systemic vascular resistance

and 5 more in the citations list

Cardiac Output

Improved cardiac output secondary to afterload reduction. Comparable efficacy to dobutamine with better safety profile.

Improves (the measure goes up)Moderate effect15 studies

Studies that measured cardiac output

and 5 more in the citations list

Global Clinical Status

Improvement in global clinical status in trials, though long-term outcomes remain under study.

Improves (the measure goes up)Moderate effect16 studies

Studies that measured global clinical status

and 6 more in the citations list

General

General: outcomes studied for Nesiritide (Natrecor)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Cardiac Protection

58 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect12 studies

Studies that measured cardiac protection

and 2 more in the citations list

Kidney Function

6 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Small effect8 studies

Studies that measured kidney function

Safety/Tolerability

5 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Small effect7 studies

Studies that measured safety/tolerability

Mortality

4 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes down)Small effect6 studies

Studies that measured mortality

Cardiac Arrhythmia

3 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes down)Small effect5 studies

Studies that measured cardiac arrhythmia

Pulmonary Function

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies
Muscle Mass/Function

2 preclinical studies support this finding. Primarily preclinical evidence.

Improves (the measure goes up)Small effect4 studies

Key findings

  • Pulmonary Capillary Wedge PressureHeart FailureImproves (the measure goes down)
  • Dyspnea ImprovementHeart FailureImproves (the measure goes up)
  • Systemic Vascular ResistanceHeart FailureImproves (the measure goes down)

Studies cited

45 studies from PubMed

  1. B-Type Natriuretic Peptide Level for Atrial Fibrillation Ablation　- Is It a Wonderful Fortune Teller or a Mirror Reflecting Reality?Circulation journal : official journal of the Japanese Circulation Society, 2023 · PMID 37899251
  2. Serum NT-ProBNP potential marker of cirrhotic cardiomyopathy.Folia medica, 2022 · PMID 36876527
  3. Natriuretic peptides and incident atrial fibrillation.American heart journal, 2021 · PMID 34600608
  4. Nesiritide in patients with acute myocardial infarction and heart failure: a meta-analysis.The Journal of international medical research, 2020 · PMID 31948318
  5. Admission NT-ProBNP in Myocardial Infarction: an Alert Sign?Arquivos brasileiros de cardiologia, 2019 · PMID 31800689
  6. Impact of Nesiritide Infusion on Early Postoperative Recovery After Total Cavopulmonary Connection Surgery.Pediatric cardiology, 2018 · PMID 29998377
  7. Biomarkers to noninvasively determine the atrial fibrillation progression phenotype: A bridge to individualized ablative therapy?Heart rhythm, 2018 · PMID 29625276
  8. Efficacy and safety of nesiritide in patients with decompensated heart failure: a meta-analysis of randomised trials.BMJ open, 2016 · PMID 26739721
  9. Natriuretic peptides for the treatment of acute heart failure: a focus on nesiritide in recent clinical trialsInt J Cardiol, 2015 · PMID 26028173
  10. The dose-dependent effect of nesiritide on renal function in patients with acute decompensated heart failure: a systematic review and meta-analysis of randomized controlled trials.PloS one, 2015 · PMID 26107522
  11. Dobutamine Therapy is Associated with Worse Clinical Outcomes Compared with Nesiritide Therapy for Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions, 2015 · PMID 26123415
  12. Renal subanalysis of the Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF): the end of nesiritide as a cardiorenal therapeutic?Circulation, 2014 · PMID 25074508
  13. Nesiritide fails to reduce the mortality of patients with acute decompensated heart failure: an updated systematic review and cumulative meta-analysis.International journal of cardiology, 2014 · PMID 25183537
  14. Does nesiritide reduce mortality and readmission in decompensated heart failure?Revista da Associacao Medica Brasileira (1992), 2012 · PMID 22569604
  15. Acute study of clinical effectiveness of nesiritide in decompensated heart failure: nesiritide reduxN Engl J Med, 2011 · PMID 21695395
  16. Cardiovascular and renal effects of carperitide and nesiritide in cardiovascular surgery patients: a systematic review and meta-analysis.Critical care (London, England), 2011 · PMID 22032777
  17. Efficacy and safety of nesiritide in patients with acute decompensated heart failure.Expert review of cardiovascular therapy, 2010 · PMID 20136602
  18. Impact of nesiritide on renal function and mortality in patients suffering from heart failure.Cardiovascular drugs and therapy, 2009 · PMID 19252976
  19. Nesiritide improves hemodynamics in children with dilated cardiomyopathy: a pilot study.Pediatric cardiology, 2009 · PMID 18704555
  20. Nesiritide: a reappraisal of efficacy and safety.Expert opinion on pharmacotherapy, 2007 · PMID 17266470
  21. Perioperative effects and safety of nesiritide following cardiac surgery in children.Journal of intensive care medicine, 2006 · PMID 16698741
  22. Short and long-term mortality with nesiritide.American heart journal, 2006 · PMID 17161057
  23. Clinical and hemodynamic effects of nesiritide (B-type natriuretic peptide) in patients with decompensated heart failure receiving beta blockersCongest Heart Fail, 2005 · PMID 15860969
  24. B-type natriuretic peptide in heart failureAm Heart J, 2005 · PMID 16601459
  25. Risk of worsening renal function with nesiritide in patients with acutely decompensated heart failure.Circulation, 2005 · PMID 15781736
  26. Nesiritide and worsening of renal function: the emperor's new clothes?Circulation, 2005 · PMID 15795361
  27. Subcutaneous administration of the cardiac hormone BNP in symptomatic human heart failureJ Card Fail, 2004 · PMID 15101022
  28. Nesiritide in pulmonary hypertension.Chest, 2004 · PMID 15249476
  29. "BNP" for heart failure: role of nesiritide in cardiovascular therapeuticsDrugs, 2003 · PMID 12368590
  30. B-type natriuretic peptide: spectrum of application. Nesiritide (recombinant BNP) for heart failureCongest Heart Fail, 2003 · PMID 14574051
  31. Nesiritide: a review of its use in acute decompensated heart failure.Drugs, 2003 · PMID 12487622
  32. Nesiritide: a novel approach for acute heart failure.The Annals of pharmacotherapy, 2003 · PMID 12549957
  33. Nesiritide: a new therapy for the treatment of heart failure.Cardiovascular toxicology, 2003 · PMID 12668889
  34. Nesiritide (Natrecor): a new treatment for acutely decompensated congestive heart failure.Critical care nursing quarterly, 2003 · PMID 12669946
  35. Brain natriuretic peptide (nesiritide) in the treatment of heart failureAm J Cardiol, 2002 · PMID 12070532
  36. Nesiritide: a new drug for the treatment of decompensated heart failureCleve Clin J Med, 2002 · PMID 12232567
  37. Nesiritide (Natrecor): a new therapy for acutely decompensated congestive heart failureCleve Clin J Med, 2002 · PMID 11855159
  38. How to use nesiritide in treating decompensated heart failure.Cleveland Clinic journal of medicine, 2002 · PMID 11890216
  39. Nesiritide: review of clinical pharmacology and role in heart failure management.Heart disease (Hagerstown, Md.), 2002 · PMID 12028606
  40. Safety and efficacy of nesiritide for the treatment of decompensated heart failure.Reviews in cardiovascular medicine, 2002 · PMID 12439428
  41. Nesiritide for the treatment of decompensated heart failure.Journal of cardiac failure, 2001 · PMID 11264555
  42. Nesiritide: a unique therapeutic cardiac peptide.Reviews in cardiovascular medicine, 2001 · PMID 12439359
  43. An update on nesiritide for treatment of decompensated heart failureCongest Heart Fail, 2000 · PMID 11322867
  44. Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure. Nesiritide Study GroupN Engl J Med, 2000 · PMID 11723271
  45. Sustained hemodynamic effects of an infusion of nesiritide (human b-type natriuretic peptide) in heart failure: a randomized, double-blind, placebo-controlled clinical trial. Natrecor Study Group.Journal of the American College of Cardiology, 1999 · PMID 10400005