Key result
Systematic review finds no evidence evaluating point-of-care natriuretic peptide testing in PAH.
Why the study?
Pulmonary arterial hypertension remains life-shortening with unchanged time to diagnosis, focusing current strategies on earlier diagnosis and low-risk mortality categorization.
Does point-of-care testing for BNP or NT-proBNP improve diagnosis, risk stratification, or prognosis in patients with pulmonary arterial hypertension?
Systematic Review
Does point-of-care testing for BNP or NT-proBNP improve diagnosis, risk stratification, or prognosis in patients with pulmonary arterial hypertension?
While natriuretic peptide point-of-care testing is proven to reduce time-to-diagnosis in left heart failure, there is currently a complete lack of evidence regarding its clinical utility in pulmonary arterial hypertension.
Answers are grounded in this paper and cite their sources.
No evidence supports POC BNP/NT-proBNP testing in PAH; leaves open its diagnostic or prognostic utility and requires prospective trials.
Despite the advent of new therapies and improved outcomes in patients with pulmonary arterial hypertension (PAH), it remains a life-shortening disease and the time to diagnosis remains unchanged. Strategies to improve outcomes are therefore currently focused on earlier diagnosis and a treatment approach aimed at moving patients with PAH into a category of low-risk of 1-year mortality. B-type natriuretic peptide (BNP; or brain natriuretic peptide) and N-terminal prohormone of BNP (NT-proBNP) are released from cardiac myocytes in response to mechanical load and wall stress. Elevated levels of BNP and NT-proBNP are incorporated into several PAH risk stratification tools and screening algorithms to aid diagnosis of systemic sclerosis. We have undertaken a systematic review of the literature with respect to the use of BNP and NT-proBNP in PAH and the use of these biomarkers in the diagnosis and risk stratification of PAH, their relation to pulmonary haemodynamics and the potential for point-of-care testing to improve diagnosis and prognosis.
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Lewis et al. (2020) conducted a systematic review in Pulmonary arterial hypertension. BNP and NT-proBNP point-of-care testing (POCT) vs. Clinical laboratory assays was evaluated. Despite theoretical benefits for improving risk stratification and time-to-result, a systematic search identified zero studies assessing point-of-care testing for BNP or NT-proBNP specifically in patients with pulmonary arterial hypertension.
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