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How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic

Jenny A Doust1, Eva Pietrzak, Annette Dobson

  • 1Centre for General Practice, School of Medicine, University of Queensland, Herston Road, Herston, Qld 4006, Australia. j.doust@sph.uq.edu.au

BMJ (Clinical Research Ed.)
|March 19, 2005
PubMed

Insights

B-type natriuretic peptide (BNP) is a strong predictor of adverse outcomes in heart failure patients. Higher BNP levels significantly increase the risk of death and cardiovascular events in both symptomatic and asymptomatic individuals.

Area of Science:

  • Cardiology
  • Biomarkers
  • Prognostic Medicine

Background:

  • Heart failure (HF) is a complex clinical syndrome with significant morbidity and mortality.
  • Accurate prognostic markers are crucial for guiding clinical management and patient counseling in HF.
  • B-type natriuretic peptide (BNP) is a hormone released by the ventricles in response to increased wall stress.

Purpose of the Study:

  • To systematically review and assess the prognostic value of B-type natriuretic peptide (BNP) in patients with heart failure.
  • To evaluate BNP's predictive capability for mortality and cardiovascular events in both symptomatic and asymptomatic individuals.

Main Methods:

  • A systematic review of published studies was conducted using electronic searches of Medline and Embase databases.
  • Included studies assessed the relationship between BNP levels (initial and changes) and the risk of death or cardiovascular events.
  • Prognostic models, including multivariable analyses with BNP and left ventricular ejection fraction, were analyzed.

Main Results:

  • Nineteen studies in heart failure patients and five in asymptomatic individuals were included.
  • A 100 pg/ml increase in BNP was associated with a 35% increased relative risk of death in heart failure patients.
  • BNP emerged as a significant independent predictor of prognosis in numerous multivariable models.

Conclusions:

  • B-type natriuretic peptide (BNP) is a robust prognostic indicator across all stages of heart failure.
  • BNP demonstrates significant predictive power for adverse outcomes in both symptomatic and asymptomatic patient populations.
  • Despite potential limitations like publication bias, BNP offers valuable prognostic information in cardiovascular disease management.
Abstract

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