Are Serial BNP Measurements Useful in Heart Failure Management?

Desai, Akshay S.

doi:10.1161/circulationaha.112.120493

Cited by 53 publications

(19 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, owing to shifts in fluid status and wide biological variability, serial or repeat measurements during hospitalization are of questionable clinical utility and not recommended (15,16 ). To avoid confusion or misinterpretation of fluctuating NT-proBNP concentrations during hospitalization, measurement once at admission (to confirm diagnosis of heart failure if unclear) and once before discharge may be optimal (17 ).…”

mentioning

confidence: 99%

Implementation of Clinical Decision Support Rules to Reduce Repeat Measurement of Serum Ionized Calcium, Serum Magnesium, and N-Terminal Pro-B-Type Natriuretic Peptide in Intensive Care Unit Inpatients

et al. 2016

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Implementation of Clinical Decision Support Rules to Reduce Repeat Measurement of Serum Ionized Calcium, Serum Magnesium, and N-Terminal Pro-B-Type Natriuretic Peptide in Intensive Care Unit Inpatients

et al. 2016

View full text Add to dashboard Cite

show abstract

“…As a result, despite considerable amounts of information available on numerous biomarkers, inconsistent research methodologies, insufficient study size, and lack of clinical correlations have made bench-to-bedside translations rare, leaving the literature with numerous publications of varied quality. This has led to slow adoption of established biomarkers, debates about the utility of biomarkers in standard clinical care, and delays in approval by regulatory agencies for clinical use (8,9). For example, the clinical efficacy of natriuretic peptide–guided therapy in heart failure remains unclear, despite 12 studies over the last decade that included >2,500 patients; fortunately, a multicenter trial is currently underway (GUIDE-IT [Guiding Evidence Based Therapy Using Biomarker Intensified Treatment]; NCT01685840) to provide clearer recommendations (10).…”

mentioning

confidence: 99%

Charting a Roadmap for Heart Failure Biomarker Studies

Ahmad

Fiuzat

Pencina

et al. 2014

JACC: Heart Failure

View full text Add to dashboard Cite

Heart failure is a syndrome with a pathophysiological basis that can be traced to dysfunction in several interconnected molecular pathways. Identification of biomarkers of heart failure that allow measurement of the disease on a molecular level has resulted in enthusiasm for their use in prognostication and selection of appropriate therapies. However, despite considerable amounts of information available on numerous biomarkers, inconsistent research methodologies and lack of clinical correlations have made bench-to-bedside translations rare and left the literature with countless publications of varied quality. There is a need for a systematic and collaborative approach aimed at definitively studying the clinical benefits of novel biomarkers. In this review, on the basis of input from academia, industry, and governmental agencies, we propose a systematized approach based on adherence to specific quality measures for studies looking to augment current prediction model or use biomarkers to tailor therapeutics. We suggest that study quality, rather than results, should determine publication and propose a system for grading biomarker studies. We outline the need for collaboration between clinical investigators and statisticians to introduce more advanced statistical methodologies into the field of biomarkers that would allow for data from a large number of variables to be distilled into clinically actionable information. Lastly, we propose the creation of a heart failure biomarker consortium that would allow for a comprehensive list of biomarkers to be concomitantly analyzed in a pooled sample of randomized clinical trials and hypotheses to be generated for testing in biomarker-guided trials. Such a consortium could collaborate in sharing samples to identify biomarkers, undertake meta- analyses on completed trials, and spearhead clinical trials to test the clinical utility of new biomarkers.

show abstract

“…Secondly, there is controversy surrounding the usefulness of BNP as a biomarker for heart failure mechanisms, since levels vary widely in the general population based on factors including age, gender and BMI [5,6]. Specifically, elevated BNP levels can occur in conditions independent of heart failure including old age, the use of hormone replacement therapy, and obesity [7].…”

Section: To the Editormentioning

confidence: 99%