Diagnosis
Biomarkers (see Table 6)
Ambulatory/Outpatient
ÎÎIn ambulatory patients with dyspnea, measurement of B-type
natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) is
useful to support clinical decision-making regarding the diagnosis of
HF, especially in the setting of clinical uncertainty. (I-A)
ÎÎMeasurement of BNP or NT-proBNP is useful for establishing
prognosis or disease severity in chronic HF. (I-A)
ÎÎBNP-guided or NT-proBNP–guided HF therapy can be useful to
achieve optimal dosing of GDMT in select clinically euvolemic patients
followed in a well-structured HF disease management program. (IIa-B)
ÎÎThe usefulness of serial measurement of BNP or NT-proBNP to reduce
hospitalization or mortality in patients with HF is not well established.
(IIb-B)
ÎÎMeasurement of other clinically available tests such as biomarkers
of myocardial injury or fibrosis may be considered for additive risk
stratification in patients with chronic HF. (IIb-B)
Hospitalized/Acute HF
ÎÎMeasurement of BNP or NT-proBNP is useful to support clinical
judgment for the diagnosis of acute decompensated HF, especially in
the setting of uncertainty for the diagnosis. (I-A)
ÎÎMeasurement of BNP or NT-proBNP and/or cardiac troponin is useful
for establishing prognosis or disease severity in acute decompensated
HF. (I-A)
ÎÎThe usefulness of BNP-guided or NT-proBNP–guided therapy for acute
decompensated HF is not well established. (IIb-C)
ÎÎMeasurement with other clinically available tests such as tests for
biomarkers of myocardial injury or fibrosis may be considered for
additive risk stratification in patients with acute decompensated HF.
(IIb-A)
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