Effectiveness and cost-effectiveness of serum B-type natriuretic peptide (BNP or NT-BNP) testing and monitoring in patients with heart failure (HF) in primary and secondary care

Heart failure happens when the heart becomes damaged, for example after a heart attack, and cannot adequately pump blood around the body.  B-type natriuretic peptide (BNP) is a chemical secreted by the heart in response to injury and its levels in the blood increases in people with heart failure.  Doctors have suggested that measuring BNP in the blood regularly and adjusting heart failure medications to lower BNP levels (BNP-guided treatment) may be better than adjusting medications based on symptoms alone.

Several studies have been conducted in which patients are allocated by chance to receive either BNP-guided treatment or standard treatment without having BNP measured. We combined the “raw” data collected on each participant in these studies in a meta-analysis, which is a statistical technique for combining the findings from independent studies.  We requested the raw data from all investigators who conducted these studies.

We also assembled a representative group of patients with heart failure in the UK and determined whether those who have BNP measured have better outcomes than those who do not. For this we used data that are routinely collected by hospitals and GP practices in the UK.  The results from Monitor will help doctors to decide whether BP-guided treatment should be offered to all patients with heart failure in the UK.