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