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Testing for BNP and NT-proBNP in the Diagnosis and Prognosis of Heart Failure: Evidence Report/Technology Assessment


This evidence report presents the results of a systematic review to evaluate B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) as promising markers for heart failure diagnosis, prognosis, and treatment.

The evidence report is organized as follows:

  • Introduction
    • BNPs
    • Heart failure
    • Determinants of BNPs
    • Diagnosis of heart failure using BNPs
    • Prognostic utility of BNPs
    • Treatment monitoring using BNPs
    • Scope and purposes of the systematic review
  • Methods
  • Results
    • Question 1: What are the determinants of both BNP and NT-proBNP measurement?
    • Question 2a: What are the clinical performance characteristics of both BNP and NT-proBNP measurement in patients with symptoms suggestive of heart failure or with known heart failure:
      • Presenting to the emergency department?
      • In a specialized clinic or outpatient setting?
      • Presenting to a primary care setting?
      • Presenting in a long-term care setting?
      • In all settings combined?
    • Question 2b: Does measurement of BNP or NT-proBNP add independent diagnostic information to the traditional diagnostic measures of heart failure in patients with symptoms suggestive of heart failure?
    • Question 3a: Do BNP or NT-proBNP levels predict cardiac events in populations:
      • At risk for coronary artery disease (CAD)?
      • With diagnosed CAD?
      • With diagnosed heart failure?
    • Question 3b: What are the screening performance characteristics of BNP or NT-proBNP in general asymptomatic populations?
    • Question 4: Can BNP or NT-proBNP measurement be used to monitor response to therapy? 
  • Discussion
  • Conclusions
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McMaster University Evidence-based Practice Center (EPC)

Funding Sources

Agency for Healthcare Research and Quality

QualityTool Topic



  • Release Date: 09/2006
  • Original Summary: 11/2006
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Last updated: August 08, 2012.