Serial BNP - Useful or Not?

Circulation. 2013; 127: 509-516

Controversies in Cardiovascular Medicine

Are Serial BNP Measurements Useful in Heart Failure Management?

Serial Natriuretic Peptide Measurements Are Not Useful in Heart Failure Management: The Art of Medicine Remains Long

Akshay S. Desai, MD, MPH

Introduction

Natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP), have emerged as powerful markers of cardiovascular risk in patients with heart failure.1 Circulating natriuretic peptide (NP) levels add incremental prognostic value to standard clinical risk stratification algorithms for both ambulatory and hospitalized heart failure patients, with a steady increase in the risk of mortality and recurrent heart failure hospitalization as NT-proBNP levels rise above 1000 pg/mL. A systematic review of 19 studies of patients with heart failure demonstrated that for every 100-pg/mL rise in BNP concentration, there was a corresponding 35% increase in the relative risk of death...

Circulation. 2013; 127: 500-508
Are Serial BNP Measurements Useful in Heart Failure Management?

Serial Natriuretic Peptide Measurements Are Useful in Heart Failure Management

James L. Januzzi, Jr, MD; Richard Troughton, MD, PhD


Introduction

We have been asked to take the position that serial natriuretic peptide (NP) testing is useful for heart failure (HF) management. To do so, we primarily draw on our experience as physicians with active clinical practices replete with patients suffering from the diagnosis but also from our in-depth knowledge of NP testing and its strengths and weaknesses...