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August 7, 2002

Nesiritide vs Nitroglycerin for Decompensated Congestive Heart Failure—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(5):571-573. doi:10.1001/jama.288.5.571

In Reply: We agree with Dr Dunavant that no single clinical trial should be considered in isolation. We point out that another study1 has found that nesiritide is safe and effective in improving hemodynamics, specifically PCWP and pulmonary artery pressures in patients with decompensated CHF. Our trial, as well as the earlier report by Colucci et al,1 demonstrated that nesiritide led to rapid reduction in PCWP, which is directly related to improvement of CHF symptoms. Indeed, in our trial, nesiritide consistently was associated with a greater decrease in PCWP during the first 24 hours than nitroglycerin at all time points except at 2 hours.