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

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An Erratum to this article was published on 09 August 2014

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.

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Acknowledgments

This manuscript is based on the research conducted by the McMaster Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290 2007-10060-I). The findings and conclusions in this paper are those of the authors, who are responsible for its content, and do not necessarily represent the views of the Agency for Healthcare Research and Quality. No statement herein should be construed as an official position of the Agency for Healthcare Research and Quality or of the US Department of Health and Human Services. Parminder Raina holds a Tier 1 Canada Research Chair in Geroscience and the Raymond and Margaret Labarge Chair in Research and Knowledge Application for Optimal Aging.

Conflict of interest

All the authors declared that they have no conflicts of interest or financial ties to disclose.

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  1. Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, MIP Suite 309A, Hamilton, ON, L8S 4K1, Canada

    Mark Oremus, Pasqualina L. Santaguida, Judy A. Brown, Usman Ali, Amy Bustamam, Nazmul Sohel & Parminder Raina

  2. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada

    Andrew Don-Wauchope, Stephen Hill & Cynthia Balion

  3. Department of Medicine, McMaster University, Hamilton, ON, Canada

    Robert McKelvie

  4. Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada

    Ronald Booth

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Oremus, M., Don-Wauchope, A., McKelvie, R. et al. BNP and NT-proBNP as prognostic markers in persons with chronic stable heart failure. Heart Fail Rev 19, 471–505 (2014). https://doi.org/10.1007/s10741-014-9439-6

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