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01.08.2014

BNP and NT-proBNP as prognostic markers in persons with acute decompensated heart failure: a systematic review

verfasst von: Pasqualina L. Santaguida, Andrew C. Don-Wauchope, Mark Oremus, Robert McKelvie, Usman Ali, Stephen A. Hill, Cynthia Balion, Ronald A. Booth, Judy A. Brown, Amy Bustamam, Nazmul Sohel, Parminder Raina

Erschienen in: Heart Failure Reviews | Ausgabe 4/2014

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Abstract

A systematic review was undertaken to examine the evidence for B-type natriuretic peptides (BNP and NT-proBNP) as independent predictors of mortality, morbidity, or combined mortality and morbidity outcomes in persons with acute decompensated heart failure (ADHF). Electronic databases (Medline^®, Embase™, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL) were searched from 1989 to June 2012. Reference lists of included articles, systematic reviews, and the gray literature were also searched. English language studies were eligible if they included subjects with ADHF and measured BNP/NT-proBNP using FDA approved assays. Standardized forms were used to select studies, extract data, and assess risk of bias. Seventy-nine studies, ranging over followup intervals from 14 days to 7 years, evaluating levels of BNP (n = 38), NT-proBNP (n = 35), or both (n = 6) were eligible. The majority of studies predicted mortality outcomes for admission BNP/NT-proBNP levels, with fewer studies evaluating serial, change from admission, or discharge levels. In general, higher levels of admission BNP or NT-proBNP predicted greater risk for all outcomes. Decreased levels post-admission predicted decreased risk. Overall, these studies were rated as having moderate risk of bias. This systematic review shows that BNP and NT-proBNP are independent predictors of mortality (all-cause and cardiovascular) in ADHF despite different cutpoints, time intervals, and prognostic models. Findings for morbidity and composite outcomes were less frequently evaluated and showed inconsistency. Further research is required to assess cutpoints for admission, serial measurements, change following admission, and discharge levels to assist clinical decision-making.

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Titel: BNP and NT-proBNP as prognostic markers in persons with acute decompensated heart failure: a systematic review
verfasst von: Pasqualina L. Santaguida
Andrew C. Don-Wauchope
Mark Oremus
Robert McKelvie
Usman Ali
Stephen A. Hill
Cynthia Balion
Ronald A. Booth
Judy A. Brown
Amy Bustamam
Nazmul Sohel
Parminder Raina
Publikationsdatum: 01.08.2014
Verlag: Springer US
Erschienen in: Heart Failure Reviews / Ausgabe 4/2014
Print ISSN: 1382-4147
Elektronische ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-014-9442-y

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