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Q In patients with heart failure (HF), how well does B type natriuretic peptide (BNP) or its precursor form, N terminal pro-brain natriuretic peptide (NT-proBNP), predict mortality and morbidity?
Clinical impact ratings IM/Ambulatory care ★★★★★☆☆ Internal medicine ★★★★★☆☆ Cardiology ★★★★★☆☆ Emergency medicine ★★★★★★☆
METHODS
Data sources:
Medline and EMBASE/Excerpta Medica (January 1994 to March 2004) and reference lists.
Study selection and assessment:
studies in any language were selected if they evaluated the prognostic value of BNP in patients with heart failure. Studies were excluded if patients had had recent myocardial infarction or if endpoints were not clearly clinical. Study quality was assessed (ie, patient selection, completeness of follow up, and blinding).
Outcomes:
death, cardiac death, sudden death, or other cardiovascular events.
MAIN RESULTS
19 studies assessed the relation between BNP concentrations and death or cardiovascular events in patients with HF, and 5 studies assessed the same relation in asymptomatic persons. The studies were done in various clinical settings and used various BNP tests.
Patients with HF: 4 of 5 studies using continuous measures were pooled using …