What are the ACCF and AHA recommendations for the use of brain natriuretic peptide (BNP) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) testing?

Updated: Jan 08, 2018
  • Author: Donald Schreiber, MD, CM; Chief Editor: Erik D Schraga, MD  more...
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Answer

Guidelines from the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) list as a class I recommendation the use of BNP or NT-proBNP values in the diagnosis of heart failure in ambulatory patients with dyspnea, especially when the diagnosis is uncertain, as well as their use in establishing the prognosis or disease severity in ambulatory patients with chronic heart failure. The guidelines assign a class IIa recommendation to the use of BNP or NT-proBNP in determining optimal dosing for select ambulatory patients who are clinically euvolemic and are undergoing medical therapy in a well-structured heart-failure management program. [38]

For hospitalized/acute patients, the ACCF/AHA guidelines list as a class I recommendation the use of BNP or NT-proBNP in the diagnosis of acutely decompensated heart failure, especially when the diagnosis is uncertain, as well as the use of BNP or NT-proBNP and/or cardiac troponin in establishing the prognosis or disease severity of acutely decompensated heart failure in such patients. However, the guidelines state that the usefulness of BNP or NT-proBNP in guiding therapy in hospitalized/acute patients with acutely decompensated heart failure has not been well established. [38]


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