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A systematic review of BNP and NT-proBNP in the management of heart failure: overview and methods

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An Erratum to this article was published on 09 August 2014

Abstract

B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels are increased in persons with heart failure (HF); low levels of these peptides rule out HF. We systematically reviewed the literature to assess the use of BNP and NT-proBNP in the diagnosis, prognosis, and treatment for HF. We also examined the biological variation of these peptides in persons with and without HF. We searched Medline, Embase, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL for English-language studies published between January 1989 and June 2012. Supplemental searches involved the gray literature and the reference lists of included studies. Trained reviewers used standardized forms to screen articles for inclusion in the review and to extract data from included papers. We examined the risk of bias with QUADAS-2 for diagnosis studies, the Hayden criteria for prognosis studies, and the Jadad scale for treatment studies. We assessed the strength of evidence in four domains (risk of bias, consistency, directness, and precision) for the diagnosis and treatment studies. Results were reported as narrative syntheses. Additional meta-analyses were conducted for the diagnosis studies. Three hundred ten articles passed through screening and were included in the review. One hundred four articles applied to diagnostic accuracy, 190 papers pertained to prognosis, and nine articles addressed BNP- or NT-proBNP-guided treatment. Each individual paper in this series reports, summarizes, and discusses the evidence regarding diagnosis, prognosis, or treatment.

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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

Mark Oremus, Robert McKelvie, Andrew Don-Wauchope, Pasqualina L. Santaguida, Usman Ali, Cynthia Balion, Stephen Hill, Ronald Booth, Judy A. Brown, Amy Bustamam, Nazmul Sohel, and Parminder Raina have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  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, Usman Ali, Judy A. Brown, Amy Bustamam, Nazmul Sohel & Parminder Raina

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

    Robert McKelvie

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

    Andrew Don-Wauchope, Cynthia Balion & Stephen Hill

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

    Ronald Booth

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  1. Mark Oremus
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Correspondence to Parminder Raina.

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Oremus, M., McKelvie, R., Don-Wauchope, A. et al. A systematic review of BNP and NT-proBNP in the management of heart failure: overview and methods. Heart Fail Rev 19, 413–419 (2014). https://doi.org/10.1007/s10741-014-9440-0

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