BIOMARKERS IN HEART FAILURE. Nelson S. Abelardo, MD, FPCP, FPCC UP-PGH Medical Center. CLINICALLY USEFUL BIOMARKER CRITERIA. Accurate, repeated measurements must be available to clinicians at reasonable cost with short turn-around time
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Nelson S. Abelardo, MD, FPCP, FPCC
UP-PGH Medical Center
Morrow & de Lemos
Heart failure, is a major and growing public health problem and appears to result not only from cardiac overload or injury but also from a complex interplay among genetic, neurohormonal, inflammatory, and biochemical changes acting on cardiac myocytes, the cardiac interstitium or both.
An increasing number of enzymes, hormones, biologic substances, and other markers of cardiac stress and malfunction, as well as myocyte injury — collectively referred to as biomarkers — appear to have growing clinical importance.
BNP - useful in the diagnosis and risk stratification of pts with chronic HF and are better predictor of death than is plasma norepinephrine or endothelin-1
randomly assigned outpatients with NYHA cl II/III HF to current clinical guidelines (control group) or to goal of decreasing BNP < 100 pg/ml
primary end point (HF death or hosp admission for HF) occurred in 24% of patients in whom the BNP level was lowered vs 52% of the control group (p < 0.001)
Biomarkers in Heart Failure June 2011 predictor of postdischarge outcomes
HFSA 2010 GUIDELINE RECOMMENDATION 4.3 predictor of postdischarge outcomes
Routine determination of plasma beta type natriuretic
peptide (BNP) or N-terminal pro-BNP (NT-proBNP)
concentration as part of screening evaluation for
structural heart disease in asymptomatic patients is not