Structured Abstract

Contents

• Preface
• Acknowledgments
• Executive Summary
• 1. Introduction
  • B-type Natriuretic Peptides
  • Heart Failure
  • Determinants of B-type Natriuretic Peptides
  • Diagnosis of Heart Failure Using B-type Natriuretic Peptides
  • Prognostic Utility of B-type Natriuretic Peptides
  • Treatment Monitoring Using B-type Natriuretic Peptides
  • Scope and Purposes of the Systematic Review
• 2. Methods
  • Analytic Framework
  • General Methods
  • Question Specific Methods
  • Peer Review Process
• 3. Results
  • Question 1: What Are the Determinants of Both BNP and NT-proBNP?
  • Question 2a: What Are the Clinical Performance Characteristics of Both BNP and NT-proBNP Measurement in Patients with Symptoms Suggestive of HF or with Known HF?
  • Question 2b: Does Measurement of BNP or NT-proBNP Add Independent Diagnostic Information to the Traditional Diagnostic Measures of HF in Patients with Suggestive HF?
  • Question 3a: Do BNP or NT-proBNP Levels Predict Cardiac Events in Populations at Risk of CAD, with Diagnosed CAD and HF?
  • Question 3b: What Are the Screening Performance Characteristics of BNP or NT-proBNP in General Asymptomatic Populations?
  • Question 4: Can BNP or NT-proBNP Measurement Be Used To Monitor Response to Therapy?
• 4. Discussion
  • Methodological Caveats with Interpretation of BNP and NT-proBNP as Predictors of Future Cardiac Events
  • Limitations to this Systematic Review
  • Conclusions
• List of Acronyms/Abbreviations
• Glossary
• Appendixes
  • Appendix A: Search Strings
  • Appendix B: Forms
  • Appendix C: Evidence Tables
  • Appendix D: Excluded Studies
  • Appendix E: Technical Expert Panel
• References

Task Order Leaders: Cynthia Balion, PhD, FCACB; Parminder Raina, PhD (McMaster University EPC Director)

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.¹ Contract No. 290-02-0020. Prepared by: McMaster University Evidence-based Practice Center, Hamilton, ON, Canada.

Suggested citation:

Balion C, Santaguida P, Hill S, Worster A, McQueen M, Oremus M, McKelvie R, Booker L, Fagbemi J, Reichert S, Raina P. Testing for BNP and NT-proBNP in the Diagnosis and Prognosis of Heart Failure. Evidence Report/Technology Assessment No. 142. (Prepared by the McMaster University Evidence-based Practice Center under Contract No. 290-02-0020). AHRQ Publication No. 06-E014. Rockville, MD: Agency for Healthcare Research and Quality. September 2006.

This report is based on research conducted by the McMaster University Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0020).The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers; patients and clinicians, health system leaders, and policymakers, make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

Drs. Hill, McQueen, and Worster have worked on BNP-related projects with Roche Diagnostics. Drs. Santaguida, Raina, McKelvie, Balion, and Oremus have no financial interest in this field, nor do Mr. Fagbemi, Ms. Booker, or Ms. Reichert.

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