National Academy of Clinical Biochemistry (NACB) laboratory medicine guidelines on the clinical utilization and analytical issues for cardiac biomarker testing in heart failure.
Year: 2008
Type: article
Abstract: Over recent years considerable knowledge has accumulated on the clinical utilisation of the B-type natriuretic peptide (BNP) and its co-metabolite N-terminal proB-type natriuretic peptide (NT-proBNP) in the context of heart failure (HF). In July 2007 recommendations were published by the NACB on the clinical utilisation and analytical issues of these biochemical markers of HF.1,2 The latter document was a joint effort between the NACB and the International Federation of Clinical Chemistry Committee on Standardisation of Markers of Cardiac Damage.2 These two articles provide a good summary of the current state of knowledge and understanding of the BNP and NT-proBNP assays.
This review of the Guidelines focuses mainly on the use of these biomarkers in diagnosis, risk stratification, guiding management of HF and briefly mentions analytical issues covered in the second article.
For a relatively new clinical biochemistry test, an impressive evidence-base has been accumulated from multiple randomised clinical trials and well conducted cohort studies of large numbers of patients. This evidence shows that BNP and NT-proBNP improve the diagnostic accuracy for the detection of HF in patients presenting to emergency departments with dyspnoea. The higher the value, the greater the likelihood that dyspnoea is due to HF. The Table lists the level of evidence provided in the Guidelines and ranges from the best available evidence (class I, level A) to the weakest evidence (class III, level C).3
Table
Summary of Indicators.
The NACB Guidelines begin with a brief outline of the definition of HF and the physiology of BNP synthesis followed by recommendations for the use of BNP and NT-proBNP.1 I have listed each of the recommendations from the article along with the level of evidence supporting the Guideline followed by a brief comment.
Source: PubMed Central
Author: John Beilby
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W92012270