Why the study?
Can NT-proBNP and BNP levels be used as biomarkers to guide individualized pharmacological management in patients with heart failure?
Can NT-proBNP and BNP levels be used as biomarkers to guide individualized pharmacological management in patients with heart failure?
While NT-proBNP and BNP are strongly associated with heart failure prognosis, there is currently insufficient evidence to firmly recommend their use for guiding individualized pharmacological therapy.
Should not yet guide HF therapy; leaves open need for definitive RCTs on biomarker-guided outcomes.
Guidelines for the pharmacological treatment of heart failure (HF) are based on results from large clinical trials demonstrating benefit. State of the art pharmacological management of HF assumes that target doses should be the same as those used in trials. Thus equal doses are recommended for all in practical guidelines, but this strategy might not fit individual needs. NT-proBNP and BNP emerged as potential biomarkers of clinical interest in HF management. NT-proBNP and BNP are related to HF severity and to clinical status. NT-proBNP and BNP are strongly associated with prognosis across the whole spectrum of HF patients. A pilot study has shown that NT-proBNP-guided therapy is associated with improved outcome in HF. Although at present there are still few data to make firm recommendations on the use of NT-proBNP or BNP levels as biomarkers for HF management, future studies will provide further insight on this issue.
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Paulo Bettencourt (2004) studied this question.
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