title: Evidence based application of BNP/NT-proBNP testing in heart failure.
abstract: BACKGROUND
  The B-type natriuretic peptides are now available on many automated clinical analysers. Clinical practice guidelines for heart failure include recommendations for where the B-type natriuretic peptides are possibly useful for clinical practice. A number of systematic reviews considering B-type natriuretic peptides in relation to heart failure patients have been published.
  
  
  METHODS
  This review will consider the evidence presented in the systematic reviews and how this can be applied to clinical practice.
  
  
  RESULTS
  Twenty-six systematic reviews are summarised in tables considering applications to diagnostic, prognostic and guiding therapy. Important clinical considerations for these applications are discussed to facilitate appropriate implementation in the clinical laboratory.
  
  
  CONCLUSIONS
  Most clinical laboratories should be considering the appropriate implementation of the B-type natriuretic peptide as a diagnostic test to assist in ruling out heart failure. In the application of prognosis and guiding therapy a number of questions remain to be answered.
authors.affiliation: Department of Pathology and Molecular Medicine, McMaster University and Hamilton Regional Laboratory Medicine Program, Hamilton, Ontario, Canada. Electronic address: donwauc@mcmaster.ca.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Don-Wauchope
authors.affiliation: Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: McKelvie
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards*; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: B-type natriuretic peptides; BNP; Heart failure; NT-proBNP