Study designs of evaluations included in the review
Double-blind, parallel-group, randomised controlled trials (RCTs) were eligible for inclusion.
Specific interventions included in the review
Studies that compared a single infusion of nesiritide for at least 6 hours with a control treatment that did not mandate the use of a positive inotropic drug were eligible for inclusion. The included studies compared a 6-hour infusion of nesiritide versus placebo; 3 hours of nesiritide (fixed dose 0.01 to 0.03 microg/kg or adjustable dose 0.1 microg/kg per minute) versus a nitroglycerine-based control or placebo (with re-allocation of the placebo group after 3 hours to the active therapies); and a bolus of nesiritide (0.01 microg/kg per minute) for at least 12 hours versus placebo. Cointerventions included nitrates and diuretics and no positive inotropic agents in one study, while another study allowed the use of positive inotropic agents before, during and after the study drug.
Participants included in the review
Studies of patients with acutely decompensated heart failure were eligible for inclusion. In the included studies the proportion of patients in New York Heart Association category III to IV ranged from 60 to 98%.
Outcomes assessed in the review
Studies that assessed mortality within 30 days were eligible for inclusion.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.