B-type natriuretic peptide-guided versus symptom-guided therapy in outpatients with chronic heart failure

Abstract

This meta-analysis supports the hypothesis that natriuretic peptide-guided therapy is superior to symptom-guided therapy for improving clinical outcomes in CHF outpatients. However, some large RCTs failed to document significant clinical improvement in terms of mortality and morbidity using a natriuretic peptide-guided strategy; thus, any attempt to clarify this still unresolved issue by means of further basic and clinical research is recommended in the future.

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

“…Chociaż monitorowanie stanu klinicznego i dostosowywanie leczenia na podstawie zmian osoczowych stężeń NP jest akceptowalne u pacjentów z HF, dostępne w piśmiennictwie dane nie są jednoznaczne [635][636][637][638]. Dlatego też nie można powszechnie zalecić takiego postępowania.…”

Circulating microRNAs as novel biomarkers for dilated cardiomyopathy

“…Furthermore, the clinically guided up-titration strategy was reported to be suboptimal in achieving target doses of pharmacological agents in HF, which limited the therapeutic effects of the evidence-based HF medications [27][28][29]. In addition, some meta-analyses concluded that NT--proBNP-guided therapy reduced all-cause mortality in patients with HF compared with usual clinical care [30][31][32]. Thus, plasma miR-5571-5p might be a candidate biomarker to monitor the disease progression and guide reasonable therapy.…”

B-type (brain) natriuretic peptide and pruritus in hemodialysis patients

“…17 Higher concentrations of serum BNP are frequently observed in poorly weight-controlled hemodialysis patients. We initially thought the concentration of serum BNP was directly linked to that of cerebrospinal fluid (CSF) but CSF is not generally regarded as an ultrafiltrate or dialysate of plasma.…”