BNP and NT-proBNP as prognostic markers in persons with chronic stable heart failure

Abstract

Prognosis permits clinicians to separate persons with heart failure (HF) into subgroups based on likely health outcomes. Treatment is partly guided by these likely outcomes. This systematic review explores whether brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are independent predictors of prognosis in persons with chronic stable HF. We electronically searched Medline, Embase, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL for English-language articles published between 1989 and mid-2012. We utilized trained reviewers and standardized forms to screen articles for inclusion and extracted data from included articles. All included studies were summarized in narrative and tabular form. We used the Hayden criteria to assess the risk of bias. Sixteen BNP publications and 88 NT-proBNP publications were included in the systematic review. BNP was positively associated with all-cause and HF mortality. NT-proBNP was positively associated with all-cause and cardiovascular mortality. BNP and NT-proBNP levels are useful for estimating prognosis in persons with chronic stable HF. Further research is required to establish optimal cutpoints and to assess whether prognostic effects differ by age, sex, or time period.

Predictive role of circulating endothelial-derived microparticles in cardiovascular diseases

“…Recent clinical studies have been shown that short-term and long-term prognosis among heart failure persons may be reappraised and recalculated using biological marker models demonstrated to be credible in clinical practice and useful predictable tool for physicians [78][79][80][81]. Natriuretic peptides, galectin-3 (Gal-3), and high sensitive C-reactive protein (hs-CRP) were positively associated with all-cause and cardiovascular mortality and were discussed useful for estimating prognosis in persons with different cardiovascular diseases [82][83][84][85]. Therefore, a wide spectrum of biomarkers reflected immune status, proinflammatory activation, endothelial function, was tested in predictive models for cardiovascular disease patients [77].…”

The Association of Five-Year Changes in the Levels of N-Terminal Fragment of the Prohormone Brain-Type Natriuretic Peptide (NT-proBNP) with Subsequent Heart Failure and Death in Patients with Stable Coronary Artery Disease: The Heart and Soul Study

“…Elevated levels of NT-proBNP are associated with adverse cardiovascular (CV) outcomes in the setting of acute and chronic heart failure (HF) and stable coronary artery disease (CAD) [5,6,7,8,9]. …”

Prosthesis-patient mismatch and left ventricle systolic strain in patients with severe degenerative aortic stenosis, who are undergoing surgical valve replacement

“…NT-proBNP is a marker of systolic and diastolic dysfunction and a strong predictor of mortality in heart failure patients [18,19]. Markers of LV overload such as NT-proBNP have already been shown to decrease after successful AVR [20].…”