5 4
Prevention
ACC/AHA
Stage A/B HF
ACC/AHA Stage C/D HF ACC/AHA Acute/Hospitalized HF
BNP or
NT-proBNP
(COR I)
BNP or NT-proBNP
(COR IIa)
Diagnosis
Colors correspond to COR/LOE Table. For all medical therapies, dosing should be optimized and
serial assessment exercised.
*
Other biomarkers of injury or fibrosis include soluble ST2 receptor, galectin-3, and high-sensitivity
troponin.
ACC, American College of Cardiolog y; AHA, American Heart Association; ADHF, acute
decompensated heart failure; BNP, B-type natriuretic peptide; COR, Class of Recommendation;
ED, emergency department; HF, heart failure; NT-proBNP, N-terminal pro-B-type natriuretic
peptide; NYHA, New York Heart Association; and pts, patients.
Predischarge
BNP or
NT-proBNP
(COR IIa)
Diagnosis
Prognosis or added
risk stratification
At risk for HF
Ambulatory pts
with new-onset
dyspnea
NYHA class
II-IV
Acute dyspnea
to ED
Hospitalized for
ADHF
BNP or
NT-proBNP
(COR I)
Other
biomarkers of
myocardial injury
or fibrosis*
(COR IIb)
Other
biomarkers of
myocardial injury
or fibrosis*
(COR IIb)
BNP or NT-proBNP,
and cardiac troponin
(COR I)
BNP or
NT-proBNP
(COR I)
Figure 1. Biomarkers Indications for Use (2017)
