Targeting Natriuretic Peptide Levels in Heart Failure with Therapy: Does "X" Really Mark the Spot?

Journal Article (Journal Article;Review)

PURPOSE OF REVIEW: Explore controversial biomarker-guided management of patients with heart failure (HF) with reduced ejection fraction. RECENT FINDINGS: Natriuretic peptides (e.g., BNP, NT-proBNP) are elevated in HF as a result of end-diastolic stress and are used in the diagnosis and prognosis of heart failure. Natriuretic peptide levels decrease with guideline-directed medical therapy (GDMT). Multiple small studies examined whether the use of biomarker-guided therapy would be beneficial to guide HF care and potentially improve outcomes. Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT), the largest randomized control study seeking to answer that question, did not find biomarker guided therapy to be more effective than usual care in improving the primary endpoints of HF hospitalization or cardiovascular mortality in HF patients. Natriuretic peptides are important for diagnosis and prognosis in HF. GUIDE-IT showed that patients with HF and reduced ejection did not benefit from biomarker-guided strategy in terms of clinical outcomes. Future studies could focus on additional routine clinical care settings and take into account other HF phenotypes including preserved ejection fraction.

Full Text

Duke Authors

Cited Authors

  • Logan, JK; Mentz, RJ

Published Date

  • December 2019

Published In

Volume / Issue

  • 16 / 6

Start / End Page

  • 250 - 256

PubMed ID

  • 31741230

Pubmed Central ID

  • PMC6911833

Electronic International Standard Serial Number (EISSN)

  • 1546-9549

Digital Object Identifier (DOI)

  • 10.1007/s11897-019-00441-2


  • eng

Conference Location

  • United States