title: Prediction of clinical outcomes using B-type natriuretic peptides in the general population: a systematic review.
abstract: The use of B-type natriuretic peptides to predict outcomes in general populations has been investigated in a number of primary studies. A previous systematic review considering natriuretic peptides in cardiovascular disease included a subgroup of general population studies, which suggested an association with a number of clinical outcomes. 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 extract data from included articles. All included studies (n = 7) were summarized in narrative and tabular form. A general population was defined as one that was randomly selected from a community setting where no specific inclusion or exclusion criteria were specified. The seven included studies all used FDA approved assays for NT-proBNP. The range of clinical outcomes and heterogeneity did not allow for meta-analysis. The hazard ratios for predicting outcomes in the included studies ranged from 1.0 to 4.1 (all p values <0.05). The discrimination statistics reported in four studies all demonstrated statistically significant improvements in predicting outcomes. NT-proBNP is associated with heart failure, all-cause and cardiovascular mortality, and other combined cardiovascular events in a general unselected population. The discrimination statistics suggest modest improvements in risk stratification. No prospective studies exist to demonstrate the clinical utility of using B-type natriuretic peptides to predict clinical outcomes in a general population.
authors: Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
authors: Andrew C
authors: AC
authors: Don-Wauchope
authors: Pasqualina L
authors: PL
authors: Santaguida
authors: Robert
authors: R
authors: McKelvie
authors: Judy A
authors: JA
authors: Brown
authors: Mark
authors: M
authors: Oremus
authors: Usman
authors: U
authors: Ali
authors: Amy
authors: A
authors: Bustamam
authors: Nazmul
authors: N
authors: Sohel
authors: Stephen A
authors: SA
authors: Hill
authors: Ronald A
authors: RA
authors: Booth
authors: Cynthia
authors: C
authors: Balion
authors: Parminder
authors: P
authors: Raina
mesh_terms: D019468:Disease Management; D014943:Global Health; D006333:Heart Failure / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D009017:Morbidity; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D015996:Survival Rate
chemical_list: D020097:Natriuretic Peptide, Brain