Utility of natriuretic peptides to assess and manage patients with heart failure receiving angiotensin receptor blocker/neprilysin inhibitor therapy

Alan S. Maisel, Lori B. Daniels, Inder Anand, Peter A. McCullough, Sheryl L. Chow

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Levels of natriuretic peptides (NPs), such as B-type NP (BNP) and the N-terminal fragment of its prohormone (NT-proBNP), are well-established biomarkers for patients with heart failure (HF). Although these biomarkers have consistently demonstrated their value in the diagnosis and prognostication of HF, their ability to help clinicians in making treatment decisions remains debated. Moreover, some new HF drugs can affect concentrations of NPs, such as the prevention of BNP degradation by angiotensin receptor/neprilysin inhibitors (ARNIs), and may present a challenge in the interpretation of levels of BNP. Use of NT-proBNP measurement has been suggested in the context of ARNI therapy because its concentrations are not affected by neprilysin inhibition. As biomarkers are reconsidered in the context of ARNI therapy, cutoff levels and the effects of individual patient characteristics, such as renal function and age, on biomarker concentrations should be reassessed.

Original languageEnglish (US)
Pages (from-to)299-307
Number of pages9
JournalPostgraduate medicine
Volume130
Issue number3
DOIs
StatePublished - Apr 3 2018

Keywords

  • B-type natriuretic peptide (BNP)
  • Heart failure (HF)
  • N-terminal pro-B-type natriuretic peptide(NT-proBNP)
  • biomarkers
  • sacubitril/valsartan

PubMed: MeSH publication types

  • Journal Article
  • Review

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