The standard treatments currently used for acute CHF are not ideal according to Wilson S. Colucci, M.D., Professor of Medicine and Physiology and Cardiovascular Medicine, Boston University School of Medicine, and the lead author of the article. The use of dobutamine and mirinone can be limited by the dose-dependent adverse effects they have on heart rate and arrythmias.
Patients taking nitroglycerin are susceptible to developing a tolerance of the drug.
Although sodium nitroprusside is a potent vasodilator, its use is often limited by the need for close monitoring and by concern about the toxic side effects of cyanide or thiocyanide. The drug's salutary clinical and hemodynamic profile and the relative absence of adverse side effects circumvent several of the limitations we have with currently available treatments. Nesiritide also reduced the need for diuretics. There was no significant difference between treatment groups in length of therapy, length of hospitalization, readmissions, medical interventions or mortality. In both trials, the most common adverse event in the patients treated with nesiritide was dose-related hypotension, which was usually asymptomatic or mild.