Heart Failure Reviews

, Volume 19, Issue 4, pp 541–551

Prediction of clinical outcomes using B-type natriuretic peptides in the general population: a systematic review

Authors

  • Andrew C. Don-Wauchope
    • Department of Pathology and Molecular MedicineMcMaster University
  • Pasqualina L. Santaguida
    • Department of Clinical Epidemiology and BiostatisticsMcMaster University
  • Robert McKelvie
    • Department of MedicineMcMaster University
  • Judy A. Brown
    • Department of Clinical Epidemiology and BiostatisticsMcMaster University
  • Mark Oremus
    • Department of Clinical Epidemiology and BiostatisticsMcMaster University
  • Usman Ali
    • Department of Clinical Epidemiology and BiostatisticsMcMaster University
  • Amy Bustamam
    • Department of Clinical Epidemiology and BiostatisticsMcMaster University
  • Nazmul Sohel
    • Department of Clinical Epidemiology and BiostatisticsMcMaster University
  • Stephen A. Hill
    • Department of Pathology and Molecular MedicineMcMaster University
  • Ronald A. Booth
    • Department of Pathology and Laboratory MedicineUniversity of Ottawa
  • Cynthia Balion
    • Department of Pathology and Molecular MedicineMcMaster University
    • Department of Clinical Epidemiology and BiostatisticsMcMaster University
Article

DOI: 10.1007/s10741-014-9446-7

Cite this article as:
Don-Wauchope, A.C., Santaguida, P.L., McKelvie, R. et al. Heart Fail Rev (2014) 19: 541. doi:10.1007/s10741-014-9446-7

Abstract

The use of B-type natriuretic peptides to predict outcomes in general populations has been investigated in a number of primary studies. A previous systematic review considering natriuretic peptides in cardiovascular disease included a subgroup of general population studies, which suggested an association with a number of clinical outcomes. We electronically searched Medline, Embase, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL for English-language articles published between 1989 and mid-2012. We utilized trained reviewers and standardized forms to screen articles for inclusion and extract data from included articles. All included studies (n = 7) were summarized in narrative and tabular form. A general population was defined as one that was randomly selected from a community setting where no specific inclusion or exclusion criteria were specified. The seven included studies all used FDA approved assays for NT-proBNP. The range of clinical outcomes and heterogeneity did not allow for meta-analysis. The hazard ratios for predicting outcomes in the included studies ranged from 1.0 to 4.1 (all p values <0.05). The discrimination statistics reported in four studies all demonstrated statistically significant improvements in predicting outcomes. NT-proBNP is associated with heart failure, all-cause and cardiovascular mortality, and other combined cardiovascular events in a general unselected population. The discrimination statistics suggest modest improvements in risk stratification. No prospective studies exist to demonstrate the clinical utility of using B-type natriuretic peptides to predict clinical outcomes in a general population.

Keywords

Natriuretic peptideGeneral populationPrognosisDiscrimination statisticsSystematic review

Copyright information

© Springer Science+Business Media New York 2014