Natriuretic Peptides and the Management of Heart Failure.

Natriuretic peptide has been validated as a useful biomarker in the diagnosis of heart failure, although its role in guiding medical management of heart failure is not well established. We endeavored to determine if natriuretic peptide–guided therapy is associated with improved outcomes for heart failure patients. A total of 11 trials (2628 patients) comparing natriuretic peptide–guided therapy with standard therapy for heart failure patients were identified; follow-up times ranged from 3 months to 3 years. Our data indicate that natriuretic peptide levels and all-cause mortality rates do not appear to benefit from natriuretic peptide–guided therapy when compared with standard therapy. However, a decreased rate of cardiovascular events does appear to be associated with natriuretic peptide–guided therapy.