Effects of Carperitide on Degree of Pulmonary Congestion in Treatment of Acute Heart Failure

Background:Carperitide is used to treat acute heart failure (AHF) in Japan. Whether the degree of pulmonary congestion is associated with the effects of carperitide on AHF is unclear.Methods and Results:We retrospectively investigated the in-hospital outcomes and prognoses of 742 patients hospitalized for AHF between February 2015 and January 2017 and classified them into carperitide and non-carperitide groups, stratified according to the degree of pulmonary congestion. The median follow-up duration after admission was 231 days. In patients with moderate–severe pulmonary congestion, the rate of remaining congestion on chest X-ray at discharge was lower in the carperitide group than in the non-carperitide group (1.5% vs. 9.0%, P=0.004). Also, the carperitide group had significant reduction in a composite of all-cause death or rehospitalization for HF (adjusted hazard ratio, 0.62; 95% CI: 0.41–0.93; P=0.02). In patients with no–mild pulmonary congestion, carperitide was not associated with better clinical outcome.Conclusions:In the treatment of AHF with moderate–severe pulmonary congestion, carperitide is associated with more effective decongestion in the short term and better prognosis in the long term.