Implementing natriuretic peptide testing in primary care may improve screening and diagnostic algorithms for heart failure, bridging the gap between general practitioners and specialists.
May support primary care natriuretic peptide integration; leaves open need for RCTs before practice change.
The evaluation of cardiac endocrine function by means of automated robust assays has permitted the introduction of a cheap and powerful clinical tool. Plasma concentration of B-type-related natriuretic peptides is a marker of either hemodynamic or neurohormonal stress on the heart and has been validated within the diagnostic and prognostic domain in patients with suspected or ascertained heart failure, mostly in the in-hospital setting. Evidence is growing, supporting an out-of-hospital use, namely in primary care. Its implementation in this setting in screening programs and diagnostic algorithms might contribute to decrease the apparent disparity between the general practitioner and the specialist approach to disease management.
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Emdin et al. (2008) studied this question.
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