The clinical role of natriuretic peptides--importance of BNP and NT-proBNP. Implications in heart failure and acute coronary syndrome.

ABSTRACTThe Clinical Role of NatriureticPeptides – Importance of BNP and NT-proBNP. Implications in HeartFailure and Acute Coronary Syndrome Natriuretic peptides are increasingly used asbiomarkers for several clinical entities. Anoverview of the clinical applications of brainnatriuretic peptide (BNP) and N-terminalbrain natriuretic peptide (NT-proBNP) ispresented. These neurohormones are used fordiagnosis, monitoring and predictingprognosis in patients with chronic heartfailure. The indications extend to riskstratification and prognosis of acute coronarysyndromes and prognosis of acute pulmonaryembolism. An appraisal of the influence ofbeta-blockers and other drugs in themeasurement of natriuretic peptides isperformed. The clinical effectiveness oftreatment with the cardiac hormonenesiritide (human B-type natriuretic peptide)in heart failure is assessed. Recebido para publicacao: Dezembro 2003 • Aceite para publicacao: Marco 2004Received for publication: December 2003 • Accepted for publication: March 2004