title: BNP and NT-proBNP as prognostic markers in persons with chronic stable heart failure.
abstract: Prognosis permits clinicians to separate persons with heart failure (HF) into subgroups based on likely health outcomes. Treatment is partly guided by these likely outcomes. This systematic review explores whether brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are independent predictors of prognosis in persons with chronic stable HF. We electronically searched Medline, Embase, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL for English-language articles published between 1989 and mid-2012. We utilized trained reviewers and standardized forms to screen articles for inclusion and extracted data from included articles. All included studies were summarized in narrative and tabular form. We used the Hayden criteria to assess the risk of bias. Sixteen BNP publications and 88 NT-proBNP publications were included in the systematic review. BNP was positively associated with all-cause and HF mortality. NT-proBNP was positively associated with all-cause and cardiovascular mortality. BNP and NT-proBNP levels are useful for estimating prognosis in persons with chronic stable HF. Further research is required to establish optimal cutpoints and to assess whether prognostic effects differ by age, sex, or time period.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, MIP Suite 309A, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Oremus
authors.forename: Andrew
authors.initials: A
authors.lastname: Don-Wauchope
authors.forename: Robert
authors.initials: R
authors.lastname: McKelvie
authors.forename: Pasqualina L
authors.initials: PL
authors.lastname: Santaguida
authors.forename: Stephen
authors.initials: S
authors.lastname: Hill
authors.forename: Cynthia
authors.initials: C
authors.lastname: Balion
authors.forename: Ronald
authors.initials: R
authors.lastname: Booth
authors.forename: Judy A
authors.initials: JA
authors.lastname: Brown
authors.forename: Usman
authors.initials: U
authors.lastname: Ali
authors.forename: Amy
authors.initials: A
authors.lastname: Bustamam
authors.forename: Nazmul
authors.initials: N
authors.lastname: Sohel
authors.forename: Parminder
authors.initials: P
authors.lastname: Raina
mesh_terms: D002423:Cause of Death; D014943:Global Health; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D009017:Morbidity; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain