To the Editor: The report of the Trial of Intensified vs Standard Medical Therapy in Elderly Patients With Congestive Heart Failure (TIME-CHF) by Dr Pfisterer and colleagues1 showed similar efficacy of symptom-guided heart failure therapy compared with N-terminal brain natriuretic peptide (BNP)–guided therapy. Of 499 study participants, 104 (21%) had coexistent chronic obstructive pulmonary disease (COPD). However, the interaction between presence of COPD and mortality or hospital-free survival in this population was not described.
Bhaskar E. BNP-Guided Heart Failure Therapy in Older Patients. JAMA. 2009;301(20):2091-2093. doi:10.1001/jama.2009.693