Premium
State of the art: Using natriuretic peptide levels in clinical practice
Author(s) -
Maisel Alan,
Mueller Christian,
Adams Kirkwood,
Anker Stefan D.,
Aspromonte Nadia,
Cleland John G.F.,
CohenSolal Alain,
Dahlstrom Ulf,
DeMaria Anthony,
Di Somma Salvatore,
Filippatos Gerasimos S.,
Fonarow Gregg C.,
Jourdain Patrick,
Komajda Michel,
Liu Peter P.,
McDonagh Theresa,
McDonald Kenneth,
Mebazaa Alexandre,
Nieminen Markku S.,
Peacock W. Frank,
Tubaro Marco,
Valle Roberto,
Vanderhyden Marc,
Yancy Clyde W.,
Zannad Faiez,
Braunwald Eugene
Publication year - 2008
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2008.07.014
Subject(s) - medicine , heart failure , natriuretic peptide , decompensation , asymptomatic , intensive care medicine , clinical practice , emergency department , risk stratification , brain natriuretic peptide , cardiology , emergency medicine , physical therapy , psychiatry
Natriuretic peptide (NP) levels (B‐type natriuretic peptide (BNP) and N‐terminal proBNP) are now widely used in clinical practice and cardiovascular research throughout the world and have been incorporated into most national and international cardiovascular guidelines for heart failure. The role of NP levels in state‐of‐the‐art clinical practice is evolving rapidly. This paper reviews and highlights ten key messages to clinicians: NP levels are quantitative plasma biomarkers of heart failure (HF). NP levels are accurate in the diagnosis of HF. NP levels may help risk stratify emergency department (ED) patients with regard to the need for hospital admission or direct ED discharge. NP levels help improve patient management and reduce total treatment costs in patients with acute dyspnoea. NP levels at the time of admission are powerful predictors of outcome in predicting death and re‐hospitalisation in HF patients. NP levels at discharge aid in risk stratification of the HF patient. NP‐guided therapy may improve morbidity and/or mortality in chronic HF. The combination of NP levels together with symptoms, signs and weight gain assists in the assessment of clinical decompensation in HF. NP levels can accelerate accurate diagnosis of heart failure presenting in primary care. NP levels may be helpful to screen for asymptomatic left ventricular dysfunction in high‐risk patients. Published by Elsevier B.V. on behalf of European Society of Cardiology.