[BNP-guided therapy of chronic heart failure: what is the evidence?].
The use of biomarkers, such as type B natriuretic peptide (BNP, NT pro-BNP) to finely tune the treatment during the follow-up of patients with chronic heart failure is under investigation. The few existing studies published up to now suggest that this approach leads to fewer hospital readmissions and a lower mortality due to heart failure, except in patients over 75 years of age. The positive effects of the use of biomarkers seem to be due to a greater use of target doses of the medications recommended in heart failure (angiotensin converting enzyme, angiotensin receptor blockers, or beta-blockers) and to a better adhesion to guidelines. Thus, it may prove more efficient to develop efforts to increase physicians' adhesion to guidelines than to rely on the dosage of a biomarker.
Copt
Christophe
C
Service de médecine interne générale, HUG, 1211 Genève 14
Nendaz
Mathieu
M
D000368:Aged; D002908:Chronic Disease; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*
D020097:Natriuretic Peptide, Brain