Does measuring plasma levels of cardiac natriuretic peptide hormones provide diagnostic and prognostic value in patients with heart failure or acute myocardial infarction?
Measuring cardiac natriuretic peptides provides important diagnostic and prognostic information in heart failure, with immunometric assays offering superior performance over traditional radioimmunoassays.
Cardiac natriuretic peptides (ANP, BNP, and biologically active peptides of the N-terminal proANP1-98) are differently regulated in their production/secretion patterns and clearance rates; consequently, the assay for these peptides may provide complementary (or even different) pathophysiological and/or clinical information. The assay for cardiac natriuretic peptides has been utilized in clinical conditions associated with expanded fluid volume. In particular, this assay can be useful in discriminating between normal subjects and patients in different stages of heart failure and can also be considered a prognostic indicator of long-term survival in patients with heart failure and/or after acute myocardial infarction. Non-competitive immunometric assays (such as two-site IRMAs), even if more expensive, seem to be preferable to RIAs for routinary assay of cardiac peptide hormones because they generally have a better degree of sensitivity, accuracy, and precision.
Clerico et al. (Wed,) studied this question.